Does Maternity Care Coordination Influence Perinatal Health Care Utilization? Evidence from North Carolina

Abstract

Objective: To examine effects of maternity care coordination (MCC) on perinatal health care utilization among low-income women.

Data sources: North Carolina Center for Health Statistics Baby Love files that include birth certificates, maternity care coordination records, WIC records, and Medicaid claims.

Study design: Causal effects of MCC participation on health care outcomes were estimated in a sample of 7,124 singleton Medicaid-covered births using multiple linear regressions with inverse probability of treatment weighting (IPTW).

Principal findings: Maternity care coordination recipients were more likely to receive first-trimester prenatal care (p < .01) and averaged three more prenatal visits and two additional primary care visits during pregnancy; they were also more likely to participate in WIC and to receive postpartum family planning services (p < .01). Medicaid expenditures were greater among mothers receiving MCC.

Conclusions: Maternity care coordination facilitates access to health care and supportive services among Medicaid-covered women. Increased maternal service utilization may increase expenditures in the short run; however, improved newborn health may reduce the need for costly neonatal care, and by implication the need for early intervention and other supports for at-risk children.

Keywords: Maternal and perinatal care and outcomes; Medicaid; health care costs; utilization of services.