Reimbursement for Immediate Postpartum Contraception Outside the Global Fee: Improving Outcomes and Reducing Costs for Moms and Babies

References
  1. Rodriguez MI, Evans M, Espey E. Advocating for immediate postpartum LARC: increasing access, improving outcomes, and decreasing cost. Contraception 2014;90:468-71.
  2. Committee Opinion No. 670: Immediate Postpartum Long-Acting Reversible Contraception. Obstet Gynecol 2016;128:e32-7.
  3. Curtis KM, Tepper NK, Jatlaoui TC, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep 2016;65:1-103.
  4. U.S. Department of Health & Human Services Office of Population Affairs. Performance Measures: Contraceptive Care Measures. Available at: https://www.hhs.gov/opa/performance-measures/index.html. Accessed on February 12, 2018.
  5. Optimizing postpartum care. Committee Opinion No. 666. American College of Obstetricians and Gynecologists. Obstet Gynecol 2016;127:e187–92.
  6. Sok C, Sanders JN, Saltzman HM, Turok DK. Sexual Behavior, Satisfaction, and Contraceptive Use Among Postpartum Women. J Midwifery Womens Health 2016;61:158-65.
  7. Ogburn JA, Espey E, Stonehocker J. Barriers to intrauterine device insertion in postpartum women. Contraception 2005;72:426-9.
  8. Daw JR, Hatfield LA, Swartz K, Sommers BD. Women In The United States Experience High Rates Of Coverage ‘Churn’ In Months Before And After Childbirth. Health Aff (Millwood) 2017;36:598-606.
  9. Moniz MH, Chang T, Heisler M, et al. Inpatient Postpartum Long-Acting Reversible Contraception and Sterilization in the United States, 2008-2013. Obstet Gynecol 2017;129:1078-85.
  10. Institute for Healthcare Improvement. IHI Triple Aim Initiative. Available at: http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx. Accessed on February 12, 2018.
  11. Potter JE, Hopkins K, Aiken AR, et al. Unmet demand for highly effective postpartum contraception in Texas. Contraception 2014;90:488-95.
  12. Tocce KM, Sheeder JL, Teal SB. Rapid repeat pregnancy in adolescents: do immediate postpartum contraceptive implants make a difference? Am J Obstet Gynecol 2012;206:481 e1-7.
  13. Woo VG, Lundeen T, Matula S, Milstein A. Achieving higher-value obstetrical care. Am J Obstet Gynecol 2017;216:250 e1- e14.
  14. Washington CI, Jamshidi R, Thung SF, Nayeri UA, Caughey AB, Werner EF. Timing of postpartum intrauterine device placement: a cost-effectiveness analysis. Fertil Steril 2015;103:131-7.
  15. Rodriguez MI, Caughey AB, Edelman A, Darney PD, Foster DG. Cost-benefit analysis of state- and hospital-funded postpartum intrauterine contraception at a university hospital for recent immigrants to the United States. Contraception 2010;81:304-8.
  16. Gariepy AM, Duffy JY, Xu X. Cost-Effectiveness of Immediate Compared With Delayed Postpartum Etonogestrel Implant Insertion. Obstet Gynecol 2015;126:47-55.
  17. Han L, Teal SB, Sheeder J, Tocce K. Preventing repeat pregnancy in adolescents: is immediate postpartum insertion of the contraceptive implant cost effective? Am J Obstet Gynecol 2014;211:24 e1-7.
  18. Kaiser Family Foundation. Medicaid Coverage of Intrauterine Devices (IUDs) & Implants and Reimbursement Policy. Available at: https://www.kff.org/womens-health-policy/state-indicator/medicaid-cover…. Accessed February 12, 2018.
  19. American College of Obstetricians and Gynecologists Long-Acting Reversible Contraceptive Program. Medicaid reimbursement for Postpartum LARC by State. Available at: https://www.acog.org/About-ACOG/ACOG-Departments/Long-Acting-Reversible…. Accessed on February 12, 2018.
  20. Center for medicaid and CHIP Services Informational Bulletin. https://www.medicaid.gov/federal-policy-guidance/downloads/cib040816.pdf. Accessed February 12, 2018.
  21. The 6|18 Initiative. Centers for Disease Control and Prevention. Evidence Summary: Prevent Unintended Pregnancy. Available at: https://www.cdc.gov/sixeighteen/pregnancy/index.htm. Accessed on February 12, 2018.
  22. State of Michigan. Pregnancies, Abortions and Estimated Unintended Pregnancies: Females Age 15-44, Michigan Residents, 2001-2011. Available at: https://www.mdch.state.mi.us/pha/osr/Abortion/unintendestimates.asp. Accessed February 12, 2018.
  23. Kost K. Unintended Pregnancy Rates at the State Level: Estimates for 2010 and Trends Since 2002. Available at: https://www.guttmacher.org/report/unintended-pregnancy-rates-state-leve…. Accessed February 12, 2018.
About the Authors

Drs. Michelle H. Moniz, M.D., M.Sc. and Vanessa K. Dalton, M.D. M.P.H. are investigators with nationally recognized expertise in immediate postpartum LARC policy and implementation. They can provide technical support in evaluating reimbursement policy, implementing immediate postpartum LARC services at hospitals around the state, and evaluating impact on pregnancy and birth outcomes and birth-related spending.

The Program on Women's Healthcare Effectiveness Research

The Program on Women’s Healthcare Effectiveness Research (PWHER) is an interprofessional women’s health services research group housed within the Department of Obstetrics and Gynecology and the Institute for Healthcare Policy and Innovation (IHPI) at the University of Michigan.

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