Authors

Chery Raskind-Hood, Rollins School of Public Health, Emory UniversityFollow
Kathleen E. Adams, Rollins School of Public Health, Emory University
Ernest Alema-Mensah, Morehouse School of MedicineFollow
Robert M. Mayberry, Institute for Heath Care Research and Improvement, Baylor Health Care SystemFollow

Pregnancy and Delivery Costs in Georgia Medicaid: PCCM Versus Fee-for-Service Enrollees

Abstract

This study examines the enrollment, resource utilization, and prenatal care cost patterns among pregnant black and white women in Georgia’s PCCM program, Georgia Better Health Care (GBHC), compared with those acquiring pregnancy and delivery services through Georgia’s Fee for Service (FFS) sector. Birth certificate data from 1998 were linked with Medicaid enrollment and claims data from 1997 and 1998 to construct a retrospective pregnancy history for each Medicaid woman giving birth in Georgia hospitals in 1998. Total payments for pregnancy and delivery services and on the total number of prenatal care visits were derived for each woman in the sample. Multivariate logistic analyses were employed to assess the role of PCCM versus FFS in determining total payments and the likelihood of a prenatal hospitalization, length of hospital stay longer than 2 days following delivery, and cesarean section delivery. While prenatal pregnancy services and delivery costs were higher for those in PCCM than FFS, PCCM women had fewer prenatal care visits and were less likely to have delivery stays longer than 2 days postpartum compared with FFS women. The higher costs under PCCM are apparently related to the finding that this delivery system was highly associated with having more prenatal hospitalizations compared with FFS. In similar analyses conducted separately for white and black pregnant women, black women served by PCCM followed these overall results across delivery systems while there were no differences in the likelihood of a prenatal hospitalization or total prenatal care visits for whites served by PCCM versus FFS. In light of Georgia’s turn toward full capitation under its new managed care initiative, many issues regarding pregnancy services and delivery such as earlier program enrollment, coordination of care, payment policies and capitation rates will need to be addressed.

First Page

30

Last Page

42

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Recommended Citation

Raskind-Hood, Chery; Adams, Kathleen E.; Alema-Mensah, Ernest; and Mayberry, Robert M. (2006) "Pregnancy and Delivery Costs in Georgia Medicaid: PCCM Versus Fee-for-Service Enrollees," Journal of the Georgia Public Health Association: Vol. 1: No. 2, Article 5.
DOI: 10.20429/jgpha.2006.010205
Available at: https://digitalcommons.georgiasouthern.edu/jgpha/vol1/iss2/5