The Effects of Medicaid Policy Interventions on Racial Equity in Severe Maternal Morbidity
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Medicaid healthcare quality interventions (equity payment and obstetric bundled payment), Doula, Standard Care.
- Who it may be relevant to
- Registry conditions: Severe Maternal Morbidity, Maternal Death. Basic parameters: No limits · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
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.
Interventions
- Behavioral Medicaid 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 pr - Behavioral Doula
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 pre - Behavioral Standard Care
Participants receive standard care without quality interventions or doula care
Primary outcome measures
- Severe maternal morbidity (SMM) [Time frame: 20 weeks gestation through 42 days postpartum]
Secondary outcome measures (4)
- All cause mortality [Time frame: Delivery date through one year after delivery]
- Follow up for chronic conditions [Time frame: 43 days through 1 year after delivery]
- Provision of evidence care in pregnancy and postpartum [Time frame: During pregnancy and postpartum up to 1 year]
- Medicaid managed care administrator perspectives on policy interventions [Time frame: Year 3]
Eligibility criteria
Inclusion criteria
- 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 criteria
\-
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Non-randomized
- Model
- Factorial
- Masking
- Open label
- Primary purpose
- Health services research
Study locations
United States · 1 center
- University of Pittsburgh School of Public Health — Pittsburgh
Identifiers
NCT: NCT05678699 · STUDY22080184 · 1R01NR020670-01