Medicaid and State Regulation of Nurse-Midwives: The Challenge of Data Retrieval

Abstract

This article discusses one of four findings of a larger descriptive correlational health policy study, the purpose of which was to investigate relationships among state regulation of nurse-midwifery practice, utilization of certified nurse-midwives (CNM) for Medicaid funded prenatal care, and maternal newborn outcomes. The larger study showed that use of accurate data about CNM practice and subsequent health care outcomes creates a challenge for researchers because of the paucity of data related to services provided by CNMs. Barriers to adequate data collection related to CNM services, specifically those funded by Medicaid, preclude legitimate conclusions about subsequent health care policy. Methods of workforce data collection need to be addressed by health care and health policy groups to facilitate further investigation of the relationships among state regulation of CNM practice, utilization of CNMs for Medicaid-funded prenatal care and maternal newborn outcomes as they affect access to care for vulnerable populations.

Implementing the ACA: The Influence of Nurse Practitioner Regulatory Policies on Workforce, Access to Care, and Primary Care Health Outcomes

“…The third contribution of this study lies in extending the empirical literature about these variables. The modest, yet statistically significant findings support the theory that practice regulation (structure), numbers of licensed NPs/100,000 population or practice environment (process), and patient health outcomes (outcomes) are correlated and influential, as outlined in the foundational literature for this study (Goodson, ; Keleher et al, ; Rudner, O'Grady, Hodnicki, & Hanson, ; Sonenberg, ). For example, in this study, primary care management findings in the prediabetes model suggest there is a health benefit to qualifying NPs as primary care providers in Medicaid Primary Care Case Management (PCCM) programs.…”

“…Policy reform is necessary to address primary care services deficits, including the availability of primary care providers (Bodenheimer & Pham, 2010;Cassidy, 2012;Jacobson & Jazowski, 2011;Poghosyan et al, 2012). Virtually every state has at least one HPSA, indicating the need for policymakers to invest in the primary care infrastructure (Bodenheimer & Pham, 2010;USDHHS, HRSA, 2014b) because correlations among access to care, restrictive state regulatory policies, and health outcomes in vulnerable populations have been identified in the literature (Lugo, O'Grady, Hodnicki, & Hanson, 2007;Sonenberg, 2010).…”

“…Health care providers recruited from abroad are not expected to be able to address this shortage (Bodenheimer & Pham, ); however, use of NPs and physician assistants may help to close that gap (Auerbach, ; Poghosyan et al, ). Evidence has shown that associations exist among NP state regulatory policies, access to care, and health outcomes (Kuo, Loresto, Rounds, & Goodwin, ; Lugo, O'Grady, Hodnicki, & Hanson, ; Sonenberg, ). This study explores the relationships among NP regulatory policies in the 50 states and the District of Columbia and their potential impact on patient health outcomes.…”

Nature and scope of certified nurse‐midwifery practice: A workforce study

“…As the largest group of maternity care providers across the globe, midwives are needed to provide leadership at point of care, as well as on interprofessional teams and in health policy positions (Thompson, ). Understanding the nature and scope of midwifery practice can have a substantial impact on access to health care, particularly for vulnerable and underserved populations (Dawson, Nkowane, & Whelan, ; Sonenberg, ).…”

Trends in Practice Patterns and Perspectives of Colorado Certified Nurse-Midwives

“…Over 11,000 nurse-midwives are certified to practice by the American Midwifery Certification Board (AMCB; L. Ferrell, personal communication, March 9, 2015). While it is known that CNMs provide disproportionate care to vulnerable and underserved women (Declercq et al., 2001; Newhouse et al., 2011), there is a paucity of focused data related to CNM services (Sonenberg, 2010). A rapidly changing healthcare environment, with increasingly restrictive resources, makes knowledge of the healthcare practice environment for nurse midwives crucial.…”