Strong Start for Mothers and Newborns, a federal initiative to reduce preterm birth among Medicaid/CHIP beneficiaries, tested three models of enhanced prenatal care from 2013-2017: Maternity Care Homes (MCHs), Group Prenatal Care (GPC), and Birth Centers (BCs), with the goals improving quality of care and reduce rates of preterm birth and low birthweight infants and reducing costs to Medicaid during pregnancy, birth, and the infant’s first year.
Using a mixed-methods approach, the evaluation team found that Strong Start participants who received prenatal care in Birth Centers had significantly better birth outcomes and lower costs relative to similar Medicaid beneficiaries not enrolled in Strong Start. In particular, rates of preterm birth, low birthweight, and cesarean section were lower among Birth Center participants, and costs were more than $2,000 lower per mother-infant pair during birth and the following year. This despite findings that participants had substantial medical and social risks, including high rates of depression and anxiety, prior preterm birth, obesity, and barriers to attending prenatal care appointments. These promising results may be useful to state Medicaid programs seeking to improve the health outcomes of their covered populations.
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