Recorded presentation

Norma I. Gavin, PhD¹, Tzy-Mey Kuo, PhD, MPH¹, E. Kathleen Adams, PhD², M. Femi Alao, PhD³, and Brenda Colley Gilbert, PhD³. (1) RTI International, 3040 Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194, (919) 541-6432, gavin@rti.org, (2) Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322, (3) Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-22, Atlanta, GA 30341

Medicaid funds more than one-third of all deliveries in the United States and as many as two-thirds of deliveries among teens. Pregnant teens need a variety of health services during pregnancy and delivery. In this paper, we examine the use of Medicaid-covered health care services among pregnant teens and consider their impact on state Medicaid budgets. Using Medicaid enrollment and claims data for three states (Florida, Georgia, and New Jersey) in 1995, we investigated the timing of enrollment in Medicaid among 33,000 teens (<20 years) their demographic characteristics, health care use and pregnancy outcomes, and average Medicaid payments during the 9 months prior to and 3 months following delivery. Measures for the teens were compared to those of 48,600 Medicaid-covered women aged 20-24 years. We found that teens were more likely to have been enrolled in Medicaid prior to pregnancy and to have maintained coverage through the third month following delivery relative to women aged 20-24 years. Among those women not enrolling prior to pregnancy, teens were more likely to enroll later in pregnancy than women aged 20-24 years. We also found that pregnant teens were disproportionately of minority race/ethnicity and were more likely to have had smoking-related conditions (e.g. placenta previa) complicating their pregnancy relative to women aged 20-24 years. Teens were less likely to have had cesarean section than women 20-24 year olds. Across the states, teens were less or equally likely to have initiated prenatal care late in pregnancy relative to 20-24-year-olds. There was no difference in re-hospitalization in the 3 months following delivery among teens relative to 20-24 year olds. We found little difference in service use and average Medicaid payments for routine pregnancy- and delivery-related care between teens and 20-24-year-olds. In the three study states, pregnant teens accounted for one-sixth to one-fourth of all Medicaid payments made for pregnancy- and delivery-related care. Furthermore, no more than one quarter of teens and older women (ages 20-24) across the states had obtained Medicaid-covered contraception by 3 months post delivery. Women aged 20-24 were slightly more likely than teens to have received contraception, but the difference was accounted for by tubal ligation, not typically performed among teens. In the study, we found no large differences in health service use during pregnancy, delivery or the postpartum period for teens relative to 20-24-year-olds. Teens account for as much as one quarter of study states Medicaid payments for delivery.

Learning Objectives: At the conclusion of the presentation, session participants will be able to identify

(
• the major types and frequencies of Medicaid-paid services used by pregnant teens, (
• the differences in health service use between teens and slightly older women, and (
• the monetary consequences of Medicaid coverage of pregnant teens.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation