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Multi-level barriers to equitable postpartum permanent contraception.
Womens Health (Lond)
March 2025
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Background: There are several barriers to fulfillment of desired postpartum permanent contraception (PC). Prior research has primarily focused on the federal Medicaid sterilization policy as a barrier to PC; however, other barriers need to be examined.
Objectives: To explore the levels and intersections of barriers to postpartum PC that exist external to the Medicaid policy.
Is the Future of Cleft Care Financially Sustainable? An Economic Analysis of Inflation-Adjusted Reimbursements.
Cleft Palate Craniofac J
February 2025
Division of Plastic Surgery, Children's Hospital Colorado, Aurora, CO, USA.
Objective: As Medicaid continues to expand, it remains unclear if reimbursement rates for cleft care are keeping up with the national economy. The purpose of this study is to determine how financial trends in cleft lip and palate repair reimbursements compare to annual changes in the U.S.
View Article and Find Full Text PDFSpillovers From Medicaid Contraceptive Use to Non-Medicaid Patients: Evidence From New York.
Health Econ
February 2025
Department of Economics, University of Delaware, Newark, Delaware, USA.
This study examines spillovers from a 2014 New York Medicaid policy change that increased reimbursement for immediate postpartum long-acting reversible contraceptive (LARC) insertion. Using administrative data on hospital deliveries from 2011 through 2019, we analyze whether physicians who inserted immediate postpartum LARCs for Medicaid patients following the policy change were more likely to subsequently perform the procedure on non-Medicaid patients. We find significant spillovers, as physicians who first perform an immediate postpartum Medicaid LARC insertion following the 2014 payment reform are 9.
View Article and Find Full Text PDFWho's really footing the bill? Sex and ethnicity disparities in the cost of diabetic foot ulcer-related amputations in a major healthcare system.
J Foot Ankle Surg
February 2025
Albert Einstein College of Medicine, Department of Medicine, Division of Endocrinology, 1300 Morris Park Ave, Bronx, NY, 10461; Montefiore Medical Center, Department of Medicine, Division of Endocrinology, 111 E 210th street, Bronx, NY, 10467. Electronic address:
Diabetic foot ulcers (DFU)-related amputations are associated with enormous expenditures. Understanding why amputation services are more expensive for certain patients is crucial for reforming healthcare expenditure and insurance practices. This analysis examined differences in cost of DFU-related amputations services in patients insured by HealthFirst, a Medicaid-managed insurance company.
View Article and Find Full Text PDFSupporting Primary Care for Medically and Socially Complex Patients in Medicaid Managed Care.
JAMA Netw Open
February 2025
Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, Massachusetts.
Importance: In 2023, the Massachusetts Medicaid and Children's Health Insurance Program (MassHealth) required accountable care organizations (ACOs) to increase payments to primary care practices and shift to monthly payments, currently calibrated to historical revenues and enhanced practice capabilities, such as being staffed to address behavioral health needs. To prevent rewarding practices for avoiding difficult patients, future payments to primary care practices should reflect their patients' apparent need.
Objective: To describe MassHealth's initiative and a complexity-adjusted payment model.
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