The Effects of Medicaid Policy Interventions on Racial Equity in Severe Maternal Morbidity
Severe Maternal Morbidity, Maternal Death
About this trial
This is an interventional health services research trial for Severe Maternal Morbidity
Eligibility Criteria
Inclusion Criteria: Pregnant and postpartum Medicaid beneficiaries across the US Qualitative: Medicaid beneficiaries who self-identify as Black and/or live in PA Health Equity Zones Doulas who provide care to Medicaid beneficiaries in Pennsylvania Medicaid Managed Care Organization (MCO) administrators in Pennsylvania. Severe maternal morbidity and mortality outcomes will be assessed in healthcare records and for these quantitative outcomes, patients will not be recruited individually Exclusion Criteria: -
Sites / Locations
- University of Pittsburgh School of Public HealthRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Other
Other
Other
No Intervention
Medicaid healthcare quality interventions (equity payment and obstetric bundled payment) Only
Doula Only
Medicaid healthcare quality interventions (equity payment and obstetric bundled payment) + Doula
Standard Care
The investigators will employ a quasi-experimental study design to test two hypotheses: H1: SMM rates among Black people will decline after the interventions (equity payment and obstetric bundled payment), relative to people of other race groups within Pennsylvania (PA); and H2: Racial inequities in SMM will decline among those exposed to the interventions in PA, relative to those in similar states. The investigators will collect qualitative data to assess the effects of the Medicaid healthcare interventions on beneficiaries' experiences.
The investigators will test two hypotheses: H1: SMM rates among Black people will decline more after the addition of doula care in PA, relative to healthcare quality interventions alone. H2: Racial inequities in SMM will decline more among those exposed to both healthcare quality and doula care interventions in PA, relative to states implementing doula care only. The investigators will collect qualitative data to assess the effects of the Medicaid healthcare and service interventions on beneficiaries' experiences.