Preventive care visits with <scp>OB</scp>/<scp>GYNs</scp> and generalist physicians among <scp>reproductive‐age</scp> women with chronic conditions

Attanasio, Laura B.; Ranchoff, Brittany L; Jeung, Chanup; Goff, Sarah L.; Geissler, Kimberley H.

doi:10.1111/1475-6773.14100

Cited by 4 publications

(2 citation statements)

References 42 publications

(52 reference statements)

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“…Understanding inclusion of providers and overlap among Medicaid ACOs is particularly important given ongoing transitions in insurance plans, including among those insured by Medicaid, during the perinatal period [20]. Obstetrician-gynecologists (OB/GYNs) are uniquely placed as physicians because they provide preventive services and act as primary care providers for some patients and 25% of women consider their OB/GYN to be their primary care provider; however, they do not always provide the full range of preventive services offered by family physicians and internists, and have not been used to build primary care-focused ACOs [21][22][23][24][25][26]. However, OB/GYNs differ from other specialists in that some states and state Medicaid…”

Section: Introductionmentioning

confidence: 99%

Maternity care clinician inclusion in Medicaid Accountable Care Organizations

2023

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Background Medicaid Accountable Care Organizations (ACO) are increasingly common, but the network breadth for maternity care is not well described. The inclusion of maternity care clinicians in Medicaid ACOs has significant implications for access to care for pregnant people, who are disproportionately insured by Medicaid. Purpose To address this, we evaluate obstetrician-gynecologists (OB/GYN), maternal-fetal medicine specialists (MFM), certified nurse midwives (CNM), and acute care hospital inclusion in Massachusetts Medicaid ACOs. Methodology/Approach Using publicly available provider directories for Massachusetts Medicaid ACOs (n = 16) from December 2020 –January 2021, we quantify obstetrician-gynecologists, maternal-fetal medicine specialists, CNMs, and acute care hospital with obstetric department inclusion in each Medicaid ACO. We compare maternity care provider and acute care hospital inclusion across and within ACO type. For Accountable Care Partnership Plans, we compare maternity care clinician and acute care hospital inclusion to ACO enrollment. Results Primary Care ACO plans include 1185 OB/GYNs, 51 MFMs, and 100% of Massachusetts acute care hospitals, but CNMs were not easily identifiable in the directories. Across Accountable Care Partnership Plans, a mean of 305 OB/GYNs (median: 97; range: 15–812), 15 MFMs (Median: 8; range: 0–50), 85 CNMs (median: 29; range: 0–197), and half of Massachusetts acute care hospitals (median: 23.81%; range: 10%-100%) were included. Conclusion and practice implications Substantial differences exist in maternity care clinician inclusion across and within ACO types. Characterizing the quality of included maternity care clinicians and hospitals across ACOs is an important target of future research. Highlighting maternal healthcare as a key area of focus for Medicaid ACOs–including equitable access to high-quality obstetric providers–will be important to improving maternal health outcomes.

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Section: Introductionmentioning

confidence: 99%

Maternity care clinician inclusion in Medicaid Accountable Care Organizations

2023

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“…Two papers focus on the Roadmap's charge to provide coordinated, comprehensive care in the context of building communication and trust. Attanasio et al research on preventive care highlights a situation described by patients as a “hot potato” effect where the care they receive from an OB/GYN provider focuses on reproductive health but not chronic condition care and the services they receive from a primary care provider focuses on their conditions but less on their reproduction 8 . Given that most women of childbearing age only receive preventive care from one of these providers, the authors underscore the importance of making sure providers follow professional standards for preventive care, have adequate training, and that the quality and completeness of preventive care should be consistent and complete–regardless of what type of provider is offering primary care.…”

mentioning

confidence: 99%