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Addressing Maternal and Child Health Disparities Through Perinatal Home Visiting.

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Medicaid coverage is crucial for maternal health. Extending postpartum Medicaid to 12 months ensures continuous care, addressing significant coverage gaps and improving outcomes for mothers and infants.

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Area of Science:

  • Public Health
  • Health Services Research
  • Maternal Health

Background:

  • Persistent high rates of maternal morbidity and mortality in the US necessitate consistent healthcare access.
  • Medicaid is a primary payer for pregnancy, childbirth, and postpartum care in the United States.

Purpose of the Study:

  • To analyze maternal Medicaid enrollment patterns from pre-pregnancy through 12 months postpartum.
  • To identify factors associated with postpartum Medicaid coverage loss.

Main Methods:

  • Utilized Wisconsin birth certificate records linked with Medicaid enrollment data (2009-2018).
  • Employed descriptive statistics and log-binomial regression to assess coverage.
  • Examined covariates including maternal age, race/ethnicity, parity, education, and marital status.

Main Results:

  • 86.1% of mothers maintained continuous Medicaid enrollment throughout the first postpartum year.
  • Postpartum Medicaid disenrollment peaked at 3 months postpartum.
  • Maternal characteristics like age, marital status, and parity influenced unenrollment risk, with notable racial/ethnic disparities.

Conclusions:

  • Extending postpartum Medicaid coverage to 90 days could mitigate one-third of coverage loss.
  • A full 12-month postpartum Medicaid extension is recommended to ensure sustained healthcare access during a critical period.