The Effects of Medicaid Policy Interventions on Racial Equity in Severe Maternal Morbidity

What this Trial Is About

Researchers are examining how Medicaid policy changes aimed at equity affect severe maternal morbidity (SMM), maternal death, and overall maternal health. The study focuses on how Medicaid healthcare quality interventions and doula care influence health outcomes and racial disparities, especially among Black Medicaid beneficiaries in Pennsylvania compared to other states. The study also explores the experiences of Medicaid beneficiaries receiving these services under equity-focused policies. The study tests two main hypotheses: first, that Medicaid quality interventions such as equity payments and obstetric bundled payments will reduce SMM rates and racial inequities in Pennsylvania relative to other states; second, that adding doula care to these quality interventions will lead to greater reductions in SMM and racial disparities. Participants may receive standard care, Medicaid healthcare quality interventions alone, doula care alone, or a combination of both. Qualitative data will be collected to understand beneficiary experiences with these interventions. Participants include pregnant and postpartum Medicaid beneficiaries nationwide, with a focus on Black individuals and those in Pennsylvania Health Equity Zones. Medicaid Managed Care Organization administrators and doulas providing care in Pennsylvania will also be involved for qualitative research. Outcomes measured include rates of severe maternal morbidity from 20 weeks gestation to 42 days postpartum, mortality up to one year after delivery, management of chronic conditions, and evidence-based care provision during pregnancy and postpartum. The study began in January 2023 and will continue until June 2027, monitoring both quantitative health outcomes and qualitative experiences.

The Effects of Medicaid Policy Interventions on Racial Equity in Severe Maternal Morbidity