Medicaid-covered health care visits during the postpartum year: Variation by enrollee characteristics and state

Extending pregnancy-related Medicaid eligibility from 60 days to 12 months postpartum represents an important opportunity to reduce maternal mortality and racial inequities in maternal health outcomes. However, patterns of health care service use after 60 days postpartum among Medicaid enrollees are not well understood. We use Medicaid claims data representing Medicaid-covered live births in 46 states in 2018 to examine outpatient visits during the postpartum year. We find that more than three-quarters of enrollees with full-year Medicaid coverage have at least one outpatient visit between 61 days and 12 months postpartum. The share of enrollees with visits varies from 51.5% to 88.0% across states and is higher among enrollees with diagnosed physical or mental/behavioral health conditions or pregnancy/delivery complications. We also find that visits including mental/behavioral health care are more common for non-Hispanic white enrollees than non-Hispanic Black and Hispanic enrollees and for rural enrollees than urban enrollees during the postpartum year, controlling for other characteristics. These findings suggest that many Medicaid enrollees who maintain Medicaid coverage beyond 60 days postpartum will receive outpatient care but also suggest that there may be inequities in receipt of postpartum health care across and within states.