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Publications by Sarah Benatar for Health Policy Center
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More about Sarah Benatar's areas of expertise can be found on this Urban Institute expert's page.
CHIPRA Express Lane Eligibility Evaluation: Case Study of Louisiana's Express Lane Eligibility (Research Report)
Stan Dorn, Margaret Wilkinson, Sarah Benatar
With Express Lane Eligibility (ELE), a state's Medicaid and CHIP programs can rely on another agency's eligibility findings to qualify children for health coverage. This report examines Louisiana's experience with ELE, finding that Louisiana increased children's coverage and saved significant administrative costs. The first state to implement ELE's auto-enrollment option, Louisiana found that almost the same percentage of children obtained care, whether they enrolled (1) via standard Medicaid methods or (2) via ELE, with parents who consented to enrollment by accessing services. When the state changed procedures and required parents to consent by checking a box, enrollment declined by 62%.
Potential Medicaid Cost Savings from Maternity Care Based at a Freestanding Birth Center (Article)
Embry M. Howell, Ashley Palmer, Sarah Benatar, Bowen Garrett
Compared to usual obstetrical care, care by midwives at a birth center could reduce costs to the Medicaid program. This article examines whether such care reduces Medicaid costs for low income women using results from a prior study of maternal and infant outcomes at the Family Health and Birth Center in Washington, D.C. Costs to Medicaid are derived from birth center data and from national sources. Birth center care could save an average of $1,163 per birth. Policy makers should consider a larger role for midwives and birth centers in maternity care for low-risk pregnant women with Medicaid.
Midwifery Care at a Freestanding Birth Center: A Safe and Effective Alternative to Conventional Maternity Care (Research Report)
Sarah Benatar, Bowen Garrett, Embry M. Howell, Ashley Palmer
The Family Health and Birth Center in Washington, D.C. provides accessible, culturally appropriate prenatal care and delivery services to low income women. This study of the outcomes of care at that center improves on previous research by controlling for risk selection into birth center care. We find that women who receive at least two prenatal visits from birth center midwives regardless of whether they deliver at the center or in a hospital—are less likely to have a C-section and less likely to have an induced delivery. They have fewer preterm babies and their babies have higher birth weights.
Focus on the Future: Revisiting the Family Planning Research Agenda (Research Report)
Sarah Benatar, Embry M. Howell, Fiona Adams, Jennifer Rogers
This report summarizes the results of a literature review of recent family planning service delivery research (2003-2011) and presents areas for further research recommended by leading experts in the field. Identified research priorities include studies focused on various family planning models, best practices for contraceptive counseling, interactions between contraceptive counseling/care and chronic diseases, and research focused on the family planning needs of specific age groups. Continued consideration of the research landscape, increased collaborative efforts across funding agencies, and the replication of agenda-setting exercises will be critical to ensuring the growth and relevance of the field.
Best Start in Metro LA: More Insights from Parents, Home Visitors, And Community Stakeholders about the Investment and its Progress (Research Report)
Fiona Adams, Ian Hill, Sarah Benatar
Focus groups held with parents, home visitors, and community stakeholders revealed that Best Start LA, a place-based community investment in Los Angeles County designed to improve the well-being, development, and care experienced in children ages five and under, continued to receive strong support during its third year of implementation. Mothers receiving Welcome Baby! home visiting expressed great appreciation of the support the program provides. Home visitors described positive changes to the Welcome Baby! model that increased their ability to serve and retain mothers. Stakeholders similarly reported positive developments in community mobilization efforts, but continue to look for ways to become more efficient and effective.
Implementing Best Start LA: Continued Commitment in the Midst of Persistent Challenges (Research Report)
Sarah Benatar, Ian Hill, Fiona Adams
Best Start LA-a place-based investment designed to improve the well-being, development and care experienced by children ages five and under-has gained momentum in its third year and become more firmly established in the downtown Los Angeles pilot community, according to the third case study of a longitudinal evaluation of the initiative. Home visiting through Welcome Baby! has emerged as the strongest intervention being implemented through Best Start LA in the "pilot community" and could serve as a model throughout Los Angeles County. Community-level investments have also become more productive, as evidenced by the funding of two rounds of "collaborative partner" grants supporting a range of strategies to enhance community services and supports. Systems-level work has been deemphasized in the past year to allow for more focus on promising Welcome Baby! and community strategies.
Evaluation of the San Mateo County Adult Coverage and Systems Redesign Initiative (Research Report)
Embry M. Howell, Dana Hughes, Sarah Benatar, Genevieve M. Kenney, Ashley Palmer, Christine Coyer
In 2008 San Mateo County, California launched its Adult Coverage Expansion and Systems Redesign Initiative. The initiative expanded coverage for all uninsured adults below 200 percent of the poverty level and redesigned care in county safety net clinics. The program substantially improved access to care for uninsured adults, as well as improved continuity and quality of care for those served by county safety net clinics. However, access remains a problem for new enrollees, due to restrained provider supply and the economic recession. The report provides lessons for other counties as they expand coverage under national health reform.
Implementing Best Start LA: Momentum Grows in Metro LA (Research Report)
Ian Hill, Sarah Benatar
This second case study of the implementation of Best Start LA finds that the place-based investment—designed to improve the well-being, development and care experienced by children ages five and under—has made good progress during its second year, gaining momentum as it has become more firmly established in the downtown Metro LA pilot community. Welcome Baby! home visiting appears to be a high-quality service that could serve as a model throughout Los Angeles County. Community strategies have been funded through a series of "first step" contracts with various local agencies. And systems-level efforts appear to be laying the groundwork for important changes that could make Los Angeles communities more family-friendly for parents with young children.
Implementing Best Start LA in Metro LA - Slow but Steady Progress for the Place-Based Community Initiative (Research Report)
Ian Hill, Sarah Benatar, Fiona Adams, Heather Sandstrom
A case study of the initial implementation of Best Start LA-a place-based community investment in Los Angeles County designed to improve the well-being, development, and care experienced by children ages five and under-finds mostly positive results, thus far. At the family level, home visiting for pregnant and parenting mothers is off to a strong start, rendering services to nearly 750 families by the end of 2010. Community-level efforts to mobilize community members and develop family-support strategies have been slower to develop. Systems-level investments to develop family-friendly policies and services across the county are proceeding on schedule.
Swimming Upstream: Improving Access to Indigent Health Care in the Midst of Major Economic Challenges (Research Report)
Sarah Benatar, Dana Hughes, Embry M. Howell
An evaluation of San Mateo County's comprehensive health system redesign initiative finds notable improvements in access to high quality patient care for formerly uninsured adults. For example, the percent of such individuals having a usual source of care rose from 42.5 to 91.2 percent with the initiative. The initiative met with success despite mounting fiscal challenges associated with the economic recession and state budget crisis – threatening the county's ability to support these innovations. The county's efforts offer lessons for local and national policymakers, program administrators, and providers about how progress is possible despite severe financial obstacles.