Related Experiment Video
Updated: Sep 19, 2025
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Equitable Medicaid Reimbursement Policies Increase Midwifery-Led Births: An Interrupted Time Series Analysis With a
Elizabeth Simmons1,2, Kavita Singh1,2, Mollie Wood3
1Department of Maternal and Child Health, Gillings School of Global Health , UNC Chapel Hill, Chapel Hill, North Carolina.
Introduction:
Birthing people in the United States suffer from poor pregnancy outcomes and a lack of perinatal care providers, especially nurse-midwives. Prenatal and intrapartum care by a certified nurse-midwife (CNM) is associated with improved perinatal health and lower costs among low-risk pregnant people. Medicaid programs in 20 states reimburse CNMs 10% to 25% less than physicians. On January 1, 2006, an Illinois policy went into effect requiring Medicaid to reimburse CNMs at the same rate as physicians. The objective of this study was to evaluate the association between equal Medicaid reimbursement of CNMs and physicians and CNM-led births in Illinois.
Methods:
We included all live births to people aged 18 years or older in Illinois between June 1, 2003, and November 30, 2009. We used an interrupted time series analysis, with and without a synthetic control group, to assess the change in the level and trend of the proportion of CNM-attended births after the implementation of the Illinois policy.
Results:
The study period included 1,103,238 eligible live births in Illinois. Illinois and the synthetic control group were similar overall. Compared with a synthetic control group, we found an increase of 48.1 per 10,000 live births in the level of the number of births attended by a CNM (95% CI, -175.7 to 272.0) and an increasing trend of births attended by a CNM (2.8 per 10,000 live births; 95% CI, -7.4 to 13.1).
Discussion:
These findings support evidence that equitable reimbursement will help increase access to CNMs among the Medicaid population.
More Related Videos
08:07Author Spotlight: Advancing Labor Management Through Electromyometrial Imaging for Understanding Uterine Contractions
Published on: May 26, 2023
06:55Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
Related Concept Videos
01:52Regression Toward the Mean
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:15Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
01:22Standards of Care I
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include: