Managed Care Medicaid reduces pre-natal care, increases low-birthweight babies in California

Does Managed Care Hurt Health? Evidence From Medicaid Mothers,” Review of Economics and Statistics: Medicaid managed care in California has reduced the quality of prenatal care for pregnant women and increased the risk of low birthweight, premature birth and neonatal death, according to the study. Anna Aizer of Brown University and the National Bureau of Economic Research and colleagues used a longitudinal database of women in California to determine whether MMC had any effect on the quality of prenatal care and birth outcomes. According to the study, MMC was associated with large declines in the utilization of prenatal care among women under Medi-Cal or county organized health systems. The implementation of Medicaid Managed Care also was associated with low birth weight, shorter gestation periods and neonatal death among the same women. “These results provide strong evidence that health care providers responded to managed care incentives to reduce costs by limiting care and suggest that these limitations in care had negative effects on infant births,” the researchers write. They added that these “negative effects may have been especially pronounced in this population because the plans’ incentive to provide preventive care was effectively removed” (Aizer et al., Review of Economics and Statistics, August 2007).

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