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Impact of medicaid managed care on utilization of obstetric care: evidence from TennCare's early years.
South Med J. 2002 Aug; 95(8):811-21.SM

Abstract

BACKGROUND

TennCare expanded Medicaid coverage, substituting managed care for fee-for-service reimbursement in Tennessee.

METHODS

To study effects of TennCare on utilization of obstetric care (office visits, prenatal tests, care at labor/delivery), we used a before (1993) and after (1995) design with North Carolina as a control state. Data came from interviews with women with various forms of insurance, delivering in 1993 or 1995 in both states. Multivariate logistic analysis was used to control for other utilization determinants (eg, demographic factors).

RESULTS

TennCare women were only 38% as likely to have initiated prenatal care during the first trimester as those with traditional Medicaid. Ultrasonography and alpha-fetoprotein testing rates were higher for TennCare women, and the cesarean section rate was equivalent. However, access to care remained lower for TennCare than for the privately insured women.

CONCLUSIONS

Overall, relative to traditional Medicaid, TennCare did not adversely affect access to obstetric care during the program's early years.

Authors+Show Affiliations

Center for Health Policy, Law and Management, Duke University, Durham, NC 27708, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12190214

Citation

Sloan, Frank A., et al. "Impact of Medicaid Managed Care On Utilization of Obstetric Care: Evidence From TennCare's Early Years." Southern Medical Journal, vol. 95, no. 8, 2002, pp. 811-21.
Sloan FA, Conover CJ, Mah ML, et al. Impact of medicaid managed care on utilization of obstetric care: evidence from TennCare's early years. South Med J. 2002;95(8):811-21.
Sloan, F. A., Conover, C. J., Mah, M. L., & Rankin, P. J. (2002). Impact of medicaid managed care on utilization of obstetric care: evidence from TennCare's early years. Southern Medical Journal, 95(8), 811-21.
Sloan FA, et al. Impact of Medicaid Managed Care On Utilization of Obstetric Care: Evidence From TennCare's Early Years. South Med J. 2002;95(8):811-21. PubMed PMID: 12190214.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of medicaid managed care on utilization of obstetric care: evidence from TennCare's early years. AU - Sloan,Frank A, AU - Conover,Christopher J, AU - Mah,May Ling, AU - Rankin,Peter J, PY - 2002/8/23/pubmed PY - 2002/9/6/medline PY - 2002/8/23/entrez SP - 811 EP - 21 JF - Southern medical journal JO - South Med J VL - 95 IS - 8 N2 - BACKGROUND: TennCare expanded Medicaid coverage, substituting managed care for fee-for-service reimbursement in Tennessee. METHODS: To study effects of TennCare on utilization of obstetric care (office visits, prenatal tests, care at labor/delivery), we used a before (1993) and after (1995) design with North Carolina as a control state. Data came from interviews with women with various forms of insurance, delivering in 1993 or 1995 in both states. Multivariate logistic analysis was used to control for other utilization determinants (eg, demographic factors). RESULTS: TennCare women were only 38% as likely to have initiated prenatal care during the first trimester as those with traditional Medicaid. Ultrasonography and alpha-fetoprotein testing rates were higher for TennCare women, and the cesarean section rate was equivalent. However, access to care remained lower for TennCare than for the privately insured women. CONCLUSIONS: Overall, relative to traditional Medicaid, TennCare did not adversely affect access to obstetric care during the program's early years. SN - 0038-4348 UR - https://www.unboundmedicine.com/medline/citation/12190214/Impact_of_medicaid_managed_care_on_utilization_of_obstetric_care:_evidence_from_TennCare's_early_years_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=12190214.ui DB - PRIME DP - Unbound Medicine ER -