RecruitingNot ApplicableNCT05678699

The Effects of Medicaid Policy Interventions on Racial Equity in Severe Maternal Morbidity

Sponsor

University of Pittsburgh

Enrollment

10,000,000 participants

Start Date

Jan 3, 2023

Study Type

INTERVENTIONAL

Conditions

Maternal Death Severe Maternal Morbidity

Summary

The goal of this study is to learn about the effects of structural inventions, such as equity-focused Medicaid polices, on severe maternal morbidity (SMM) and mortality and maternal health. The main questions it aims to answer are: 1. What is the effect of Medicaid healthcare quality interventions on SMM? 2. What is the effect of Medicaid healthcare quality interventions + doula care? 3. What are Medicaid beneficiaries' experiences in receiving services and the potential impact of integration of doula services and equity practices? Participants will be asked to describe experiences as a result of structural interventions and focused Medicaid policies.

Eligibility

Inclusion Criteria5

Pregnant and postpartum Medicaid beneficiaries across the US
Qualitative:
Medicaid beneficiaries who self-identify as Black and/or live in PA Health Equity Zones
Doulas who provide care to Medicaid beneficiaries in Pennsylvania
Medicaid Managed Care Organization (MCO) administrators in Pennsylvania. Severe maternal morbidity and mortality outcomes will be assessed in healthcare records and for these quantitative outcomes, patients will not be recruited individually

Exclusion Criteria1

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Interventions

BEHAVIORALMedicaid healthcare quality interventions (equity payment and obstetric bundled payment)

This study has two components, with the first component being examined in Aim 1 and the first and second components being examine in aim 2. 1\) health equity incentive payment program makes available $26 million annually in Medicaid managed care organization (MCO) payments to plans that improve access to timely prenatal care and well-child visits among Black beneficiaries. The equity-focused obstetric care bundled payment model provides incentives for clinicians to improve on a wide range of pregnancy health outcomes, and specifically incentivizes improvements among Black beneficiaries

BEHAVIORALDoula

This study has two components, with the first component being examined in Aim 1 and the first and second components being examine in aim 2. 1. health equity incentive payment program makes available $26 million annually in Medicaid managed care organization (MCO) payments to plans that improve access to timely prenatal care and well-child visits among Black beneficiaries. The equity-focused obstetric care bundled payment model provides incentives for clinicians to improve on a wide range of pregnancy health outcomes, and specifically incentivizes improvements among Black beneficiaries. 2. care intervention by coverage of doula services for all Medicaid beneficiaries across Pennsylvania.

BEHAVIORALStandard Care

Participants receive standard care without quality interventions or doula care