Geographic Variation In Effective Contraceptive Use Among Medicaid Recipients In 2018

Area of Science:

• Public Health
• Health Services Research
• Reproductive Health

Background:

• Medicaid is the primary payer for publicly funded contraception in the U.S.
• Geographic variations in contraceptive service provision for Medicaid beneficiaries are not well understood.
• Effective contraceptive methods are crucial for reproductive health and family planning.

Purpose of the Study:

• To examine county-level variations in the provision of effective contraceptive methods among Medicaid recipients.
• To assess geographic disparities in the uptake of long-acting reversible contraception (LARC) within the Medicaid population.
• To identify potential areas for improving contraceptive access for millions of women.

Main Methods:

• Analysis of national Medicaid claims data from 40 states and Washington, D.C. for the year 2018.
• Assessment of county-level rates for the provision of most or moderately effective contraceptive methods.
• Evaluation of county-level rates for the provision of long-acting reversible contraception (LARC).

Main Results:

• County-level rates for most or moderately effective contraceptive use varied nearly fourfold (10.8% to 44.4%).
• Rates of LARC provision showed a tenfold variation across counties (1.0% to 9.6%).
• Significant geographic disparities in contraceptive access and use exist within and across states for Medicaid recipients.

Conclusions:

• Despite contraception being a core Medicaid benefit, access and utilization differ substantially by geographic location.
• Medicaid agencies can implement strategies to improve access, such as removing utilization controls and adjusting reimbursement.
• Ensuring a full range of contraceptive method choices requires targeted interventions to address geographic barriers.