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  • Title: Primary care case management and birth outcomes in the Iowa Medicaid program.
    Author: Schulman ED, Sheriff DJ, Momany ET.
    Journal: Am J Public Health; 1997 Jan; 87(1):80-4. PubMed ID: 9065232.
    Abstract:
    OBJECTIVES: This study compares prenatal care utilization and birth outcomes between Iowa Medicaid recipients receiving care in a primary care case management (PCCM) system and those receiving care in a fee-for-service (FFS) system. METHODS: Birth certificates linked with Medicaid hospitalization claims were analyzed for seven PCCM and seven FFS counties. RESULTS: From 1989 through 1992, there was (1) a 20% increase in the number of women who received adequate prenatal care in the FFS counties, vs a 5% increase in the PCCM counties; (2) a 17% increase in the number of women who initiated care within the first trimester in the FFS counties, vs a 6% increase in the PCCM counties; and (3) a 442% increase in the number of women who received enhanced prenatal services in the FFS counties, vs a 278% increase in the PCCM counties. There were no significant differences between groups in mean gestational age or birthweight; however, there was an increase of very-low-birthweight babies in both groups. CONCLUSIONS: PCCM, as implemented by the Iowa Medicaid program, has not appreciably improved prenatal care utilization or birth outcomes.
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