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November/December 2014 St@teside

State Medicaid Agencies' Role in Reducing Early Elective Deliveries

A new study in the December issue of Health Affairs—led by Medicaid Medical Directors in conjunction with AcademyHealth and with funding support from the Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services, and the Health Resources and Services Administration—examines the role state Medicaid programs are playing in reducing the number of early elective deliveries. In this study, 22 state Medicaid programs with their Maternal and Child Health and Vital Statistics state colleagues sought to coordinate quality improvement efforts related to early elective deliveries in the Medicaid population. The study finds that almost 9 percent of the 1.8 million-plus Medicaid births each year are early elective deliveries resulting in a higher rate of neonate and neonatal intensive care unit (NICU) admissions or transfers compared to full-term elective deliveries. Furthermore, these deliveries contribute to increased morbidity rates and costs.

While the study also found that early elective delivery rates among Medicaid births dropped between 2007-2012, they still need to be reduced more. Finally, the study identifies policies implemented in states to reduce the rate of these births, including prior authorization (i.e., patients getting permission from their Medicaid plan to have an early, elective birth) and “hard stop” policies (i.e., hospitals prohibiting such procedures), as well as education and feedback efforts targeting patients and physicians.

To access the Health Affairs article, visit this link:

Additional analysis of the 22-states’ data can be found here: