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Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse
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Special report: implementing immediate postpartum LARC in Florida.

Jewel A Brown1, Lindsay T Greenfield2, Rachel B Rapkin1

  • 1Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, FL.

American Journal of Obstetrics and Gynecology
|December 24, 2019
PubMed
Summary

Florida

Area of Science:

  • Reproductive Health
  • Healthcare Policy
  • Maternal Care

Background:

  • Postpartum contraception access is crucial for many women.
  • Long-acting reversible contraceptives (LARCs) are highly effective but face access barriers.
  • Reimbursement policies historically limited LARC placement in the postpartum period.

Purpose of the Study:

  • To evaluate the implementation of Florida's Access LARC initiative.
  • To assess the impact of unbundled LARC reimbursement on postpartum contraception.
  • To identify challenges and successes in providing postpartum LARCs.

Main Methods:

  • The Florida Perinatal Quality Collaborative designed a two-phase initiative (preimplementation and implementation).
  • A pilot hospital implemented the initiative following preimplementation steps.
Keywords:
LARCpostpartum

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  • Data collection focused on LARC placements and reimbursement processes.

    • Main Results:

    • One pilot hospital successfully placed 195 long-acting reversible contraceptives in 5 months.
    • Setbacks in reimbursement occurred but were overcome with assistance.
    • The initiative demonstrated success for providers and patients.

    Conclusions:

    • Florida's Access LARC initiative successfully increased postpartum LARC utilization.
    • Unbundling LARC fees improved access to long-acting reversible contraceptives.
    • The initiative's guidelines can inform other states seeking to improve postpartum contraception.