The Effects of Medicaid Policy Interventions on Severe Maternal Morbidity

Conditions

• Maternal Death
• Severe Maternal Morbidity

Eligibility Criteria

Sex

ALL

Age

N/A - N/A

Healthy Volunteers

Accepted

Interventions

• Medicaid healthcare quality interventions (incentive payment and obstetric bundled payment) — BEHAVIORAL
  This study has two components, with the first component being examined in Aim 1 and the first and second components being examined in aim 2. 1\) incentive payment program makes available $26 million annually in Medicaid managed care organization (MCO) payments to plans that improve access to timely prenatal care. The obstetric care bundled payment model provides incentives for clinicians to improve on a wide range of pregnancy health outcomes, and specifically incentivizes improvements among beneficiaries at risk for poor outcomes.
• Doula — BEHAVIORAL
  This study has two components, with the first component being examined in Aim 1 and the first and second components being examined in aim 2. 1. Incentive payment program makes available $26 million annually in Medicaid managed care organization (MCO) payments to plans that improve access to timely prenatal care. The obstetric care bundled payment model provides incentives for clinicians to improve on a wide range of pregnancy health outcomes, and specifically incentivizes improvements among beneficiaries at risk for poor outcomes. 2. care intervention by coverage of doula services for all Medicaid beneficiaries across Pennsylvania.
• Standard Care — BEHAVIORAL
  Participants receive standard care without quality interventions or doula care

Study Details

The goal of this study is to learn about the effects of Medicaid policy interventions 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? Participants will be asked to describe experiences as a result of Medicaid policy interventions and focused Medicaid policies.

Key Dates

First listed

Jan 10, 2023

Start date

Jan 3, 2023

Status verified

Sep 2026

Primary completion

Jun 30, 2027

Completion

Jun 30, 2027

Study Design

Enrollment

10,000,000 participants (estimated)

Allocation

NON_RANDOMIZED

Intervention model

FACTORIAL

Primary purpose

HEALTH_SERVICES_RESEARCH

Arms

• Other: Medicaid healthcare quality interventions (incentive payment and obstetric bundled payment) Only
  The investigators will employ a quasi-experimental study design to test two hypotheses: H1: SMM rates will decline among populations at risk after the interventions (incentive payment and obstetric bundled payment) within Pennsylvania (PA); and H2: SMM will decline among those exposed to the interventions in PA, relative to those in similar states. The investigators will collect qualitative data to assess the effects of the Medicaid healthcare interventions on beneficiaries' experiences.
• Other: Doula Only
  The investigators will test two hypotheses: H1: SMM rates will decline among populations at risk after the addition of doula care in PA, relative to healthcare quality interventions alone. H2: SMM will decline more among those exposed to both healthcare quality and doula care interventions in PA, relative to states implementing doula care only. The investigators will collect qualitative data to assess the effects of the Medicaid healthcare and service interventions on beneficiaries' experiences.
• Other: Medicaid healthcare quality interventions (incentive payment and obstetric bundled payment) + Doula
• No Intervention: Standard Care

Primary Outcome Measure

Severe maternal morbidity (SMM) [ Time Frame: 20 weeks gestation through 42 days postpartum ]

Locations (1)

Find similar trials in Pittsburgh, PA

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