Medicaid Managed Care and Infant Health: A National Evaluation

Robert Kaestner, Lisa Dubay, Genevieve Kenney

NBER Working Paper No. 8936
Issued in May 2002
NBER Program(s):Children, Health Economics

In this study, we examine the effects of Medicaid managed care (MMC) on prenatal care utilization and infant health. We obtain separate estimates of the effect of primary care case management (PCCM) managed care programs and HMO managed care plans on prenatal care utilization, birth weight, and cesarean section. The results suggest the following: MMC was associated with a small, clinically unimportant decrease in the number of prenatal care visits; MMC had no statistically significant relationship to the APNCU index of the adequacy of prenatal care; MMC was associated with a significant increase in the incidence of low-birth weight and pre-term birth; and MMC had no association with the incidence of cesarean section. We argue that a causal interpretation of the first and third findings is unsupported by a careful reading of the evidence, and we conclude that Medicaid managed care had virtually no causal effect on, prenatal care use, birth outcomes, and cesarean section.

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Document Object Identifier (DOI): 10.3386/w8936

Published: Kaestner, Robert, Lisa Dubay and Jenny Kenney. “Managed Care and Infant Health: An Evaluation of Medicaid in the US.” Social Science and Medicine 60 (2005): 1815-1833.

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