Optimizing Medicaid Extended Postpartum Coverage to Drive Health Care System Change

Zephyrin, Laurie; Johnson, Kay

doi:10.1016/j.whi.2022.08.008

Cited by 5 publications

(9 citation statements)

References 17 publications

(15 reference statements)

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“…Because the PME has gained momentum as a strategy for improving maternal health, 23,24 particularly for the Black population which is disproportionately affected by the maternal health crisis, examining the extent to which Black birthing persons are expected to benefit from the PME in Illinois is important. Whether examining the racial/ethnic-specific prevalence of the WWV (BRFSS data, Strategy 1 Baseline) or the racial/ethnic-specific prevalence of a prepregnancy check-up (PRAMS data, Strategy 1 Baseline), Black women/birthing persons have the highest rates of well-woman care in the <138% and 138-213% FPL groups in both datasets, and in the >213% FPL based on the BRFSS data.…”

Section: Discussionmentioning

confidence: 99%

Preparing for the Postpartum Medicaid Extension Evaluation in Illinois

Handler,

Krause,

Rankin

2024

Preprint

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Background: Given increased attention to the maternal health crisis, its heavy toll on Black birthing persons, and recognition that most pregnancy-related deaths occur in the extended postpartum period, Illinois implemented a Postpartum Medicaid Extension (PME). Objectives: The purpose of this study was to use baseline data from the pre-PME period to ascertain which groups of eligible persons can be expected to experience improved outcomes as a result of PME implementation in Illinois. Methods: We focused on the Well-Woman Visit (WWV) as it can be measured in the later postpartum period and is relevant for non-pregnant women. We provide baseline prevalence estimates for WWV receipt using PRAMS and BRFSS data within income strata and within combined income-insurance strata with particular attention to the income group most likely to be affected by the PME. Using multivariable binomial regression, we generate adjusted prevalence differences across income and insurance strata overall and by race/ethnicity. Results: The Illinois PME has the potential to improve the receipt of well-woman care in the 138-213% FPL income group, the group most likely to be affected by the PME. The analysis also suggests that Black women in Illinois may not be the group most likely to benefit from the enhanced access to care made available by the PME without additional focused attention to their particular needs and experiences. Conclusions and Implications for Practice and Policy: The PME is necessary but not sufficient for addressing racial/ethnic inequities in maternal health. Leveraging the opportunity that the PME provides to design and support delivery models that maximize the effects of such coverage will be essential to address the maternal health crisis in Illinois. Without extra attention to the needs and experiences of Black women, focused on the delivery of care as well as the structural determinants of health including institutional and interpersonal racism, the benefits of the PME for Black women may not be fully realized.

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Section: Discussionmentioning

confidence: 99%

Preparing for the Postpartum Medicaid Extension Evaluation in Illinois

Handler,

Krause,

Rankin

2024

Preprint

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“…A study from the US Department of Health and Human Services has shown that the systemic factors and community factors, including disparities in healthcare coverage, preventive care, lack of coordinated healthcare and social services, and inadequate physical access to transportation and housing, were identified as factors associated with maternal deaths [9]. Moreover, extending medical aid coverage for pregnant women in both regions and time ranges has positively impacted the pregnancy-related mortality rate [10]. Data showed that, in the state that promoted insurance aid expansion, maternal mortality dropped by 1.6 death per pregnant woman [10].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, extending medical aid coverage for pregnant women in both regions and time ranges has positively impacted the pregnancy-related mortality rate [10]. Data showed that, in the state that promoted insurance aid expansion, maternal mortality dropped by 1.6 death per pregnant woman [10]. Legalizing abortion and making systematic termination of pregnancy widely available would drastically reduce maternal mortality and morbidity associated with unsafe abortion (Stevenson,2021).…”

Section: Introductionmentioning

confidence: 99%

Maternal mortality and its potential risk factors

2023

International Conference on Modern Medicine and Global Health (ICMMGH 2023)

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“…1 When stratified by race, as a proxy for racism, Black mothers and birthing people suffer a disproportionate number of deaths after 6 weeks postpartum and up to 1 year after birth when compared with white women (14.9% vs. 10.2%). 2 Approximately 60% of pregnancy-related deaths are preventable. Thus, the ethics of postpartum care raises several questions around the lack of widespread acknowledgment and uptake of evidence into the development, implementation, and evaluation of policies and practices to close the postpartum death gap.…”

mentioning

confidence: 99%

“…Specifically, 1 in 8 people who die are lost after the standard 6-week appointment 1. When stratified by race, as a proxy for racism, Black mothers and birthing people suffer a disproportionate number of deaths after 6 weeks postpartum and up to 1 year after birth when compared with white women (14.9% vs. 10.2%) 2. Approximately 60% of pregnancy-related deaths are preventable.…”

mentioning

confidence: 99%

Destigmatizing and Democratizing Postpartum Care: A “Black Woman-Person First” Approach

Scott¹,

Davis

2022

Clinical Obstetrics &Amp; Gynecology

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Optimizing postpartum care highlights the need for care coordination, enhancement, and expansion of health care services after childbirth. Yet the prioritization of disease surveillance, management, and mitigation during birth and beyond within the American College of Obstetrics and Gynecology facilitates the medicalization and pathologization of Black bodies, voices, and power. Thus, we offer the Building and Bridging Black Futures Beyond Birth Model: A 12-Step Black Woman-Person First Approach, as a more humane and holistic model of culturally affirming and clinically responsive care. Destigmatizing and democratizing care bridges the gap between intent and impact in postpartum care optimization, particularly for Black women, girls, and gender expansive people and their communities.

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Optimizing Medicaid Extended Postpartum Coverage to Drive Health Care System Change

Cited by 5 publications

References 17 publications

Preparing for the Postpartum Medicaid Extension Evaluation in Illinois

Preparing for the Postpartum Medicaid Extension Evaluation in Illinois

Maternal mortality and its potential risk factors

Destigmatizing and Democratizing Postpartum Care: A “Black Woman-Person First” Approach

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