Medicaid maternal and child health care: prepaid plans vs. private fee-for-service

A randomly selected sample of 98 inner-city new mothers was interviewed with regard to (a) their level of satisfaction with and perceived barriers to pediatric and maternal health care, and (b) the health status of their infants. The mothers were divided according to their Medicaid status: 39 (40%) were enrolled into a Medicaid prepaid plan (PPP) and 59 (60%) were enrolled as regular Medicaid fee-for-service (FFS) patients. Comparison of the two groups showed that infant health status was similar but that PPP mothers reported a higher incidence of untreated infant problems and perceived more barriers to pediatric care. Birth outcomes also were similar for the two groups but FFS mothers and infants were hospitalized for significantly longer periods postpartum. The implications of these findings for the delivery of maternal and child health services to low-income populations through the Medicaid program are discussed.