Working Paper: NBER ID: w8936
Authors: Robert Kaestner; Lisa Dubay; Genevieve Kenney
Abstract: 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.
Keywords: No keywords provided
JEL Codes: I1
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| medicaid managed care (mmc) (I18) | number of prenatal care visits (J13) |
| medicaid managed care (mmc) (I18) | apncu index of the adequacy of prenatal care (J13) |
| medicaid managed care (mmc) (I18) | incidence of low birth weight (J19) |
| medicaid managed care (mmc) (I18) | incidence of preterm birth (J19) |
| medicaid managed care (mmc) (I18) | cesarean section rates (J13) |