Implementation of mandatory Medicaid managed care in Missouri: impacts for pregnant women.

Objectives: To assess the impact of mandatory Medicaid managed care in Missouri on prenatal care, maternal behavior, and low birth weight among pregnant women enrolled in Medicaid.

Study Design: Pre-post design using a comparison group with birth certificate and Medicaid enrollment data in 1995 and 2000.

Methods: Pregnant women delivering in 38 counties that implemented managed care in Medicaid were compared preimplementation and postimplementation with pregnant women delivering under Medicaid in 78 counties that remained fee-for-service (FFS) for separate samples of white (37,561) and black (13,640) non-Hispanic women.

Moving to mandatory Medicaid managed care in Ohio: impacts on pregnant women and infants.

Background: Understanding the impacts of Medicaid managed care on pregnant women is critical because Medicaid covers more than a third of all births nationally, many under managed care arrangements.

Objectives: We sought to examine the impacts of mandatory Health Maintenance Organization (HMO) enrollment on prenatal care use, smoking, and birth weight for Medicaid-covered pregnant women in Ohio.

Research Design: Impact estimates are derived from a pre-post design with a comparison group, using Ohio birth certificate data linked to Medicaid enrollment files.