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Medicaid prenatal care: a comparison of use and outcomes in fee-for-service and managed care.

机译：医疗补助产前护理：按服务收费和管理式护理的用途和结果的比较。

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BACKGROUND. To control rising costs, state Medicaid agencies are enrolling recipients in managed care health plans (MCPs). We performed this study to assess this policy's impact on accessibility and outcomes of Medicaid-funded prenatal care. METHODS. We performed a retrospective, controlled study with three cohorts: a study group of 1106 Medicaid recipients enrolled in three MCPs, a matched comparison group of 4830 recipients receiving care in the fee-for-service (FFS) system, and a second matched comparison group of 4434 non-Medicaid enrollees of the same MCPs. Data on prenatal care use and birth outcomes were obtained through linkage of claims and discharge files with birth certificate files. RESULTS. Medicaid recipients enrolled in MCPs used prenatal care similarly to those in the FFS system and showed equal or modestly improved birth-weight distributions. However, Medicaid MCP enrollees showed poorer use of prenatal care and birth outcomes compared with non-Medicaid enrollees of the same plans. CONCLUSIONS. Enrollment in MCPs has a neutral or small beneficial effect on the prenatal care received by the Medicaid population. However, providing financial access and modifying the system of care for this population did not result in parity with the general population.
机译：背景。为了控制成本的上升，州医疗补助机构正在将接受者纳入管理式医疗计划（MCP）中。我们进行了这项研究，以评估该政策对医疗补助资助的产前护理的可及性和结果的影响。方法。我们进行了一项包括三个队列的回顾性对照研究：一个研究组，参加了三个MCP的1106名Medicaid接受者；一个配对比较组，其中4830个接受了有偿服务（FFS）系统护理的接受者；另一个是配对比较组同一MCP的4434名非医疗补助参与者。通过将索赔和出院档案与出生证明档案联系起来，获得有关产前护理使用和出生结局的数据。结果。参加MCP的医疗补助接受者与FFS系统中的接受者一样使用了产前保健，并显示出相同或适度的出生体重分布改善。但是，与相同计划的非医疗补助参加者相比，医疗补助MCP参加者显示出对产前保健和出生结局的使用较差。结论。参加MCP对医疗补助人群接受的产前保健产生中性或小规模的有益影响。但是，为该人群提供经济机会并修改其护理系统并不能与普通人群平起平坐。

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