Prepaid versus traditional Medicaid plans: lack of effect on pregnancy outcomes and prenatal care.
AUTOR(ES)
Carey, T S
RESUMO
Enrollment of Medicaid recipients into capitated, case-managed systems has been advocated as a method of controlling cost. We studied prenatal care and birth outcomes for women and children enrolled in Aid to Families with Dependent Children (AFDC) in two capitated programs in Santa Barbara, California and Jackson County, Missouri (Prepaid), compared with similar but fee-for-service comparison medical communities in Ventura County, California and St. Louis, Missouri (FFS). At the sites of care, 2,336 inpatient and 823 prenatal care records were abstracted. Women at all sites received fewer than the recommended number of prenatal visits. At no site did more than 40 percent of women receive prenatal care in the first trimester of pregnancy. Mean birth weight and proportion of children of low birth weight (less than 2,500 grams) were similar between the demonstration and comparison counties. Complications of pregnancy and cesarean section rates were also similar between demonstration and comparison counties. This study did not demonstrate a decreased quality of care provided to enrollees in capitated, case-managed Medicaid programs compared with fee-for-service. Basic prenatal care was provided only to some members of this population, regardless of the type of physician payment.
ACESSO AO ARTIGO
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1069818Documentos Relacionados
- Birth outcomes and the effectiveness of prenatal care.
- Consumer Sponsorship and Physician Sponsorship of Prepaid Group Practice Health Plans: Some Similarities and Differences
- Mental health care utilization in prepaid and fee-for-service plans among depressed patients in the Medical Outcomes Study.
- Medicaid policy and the substitution of hospital outpatient care for physician care.
- A comparison of capitated and fee-for-service Medicaid reimbursement methods on pregnancy outcomes.