Moving to Mandatory Medicaid Managed Care in Ohio

Impacts on Pregnant Women and Infants

This article assesses the effect of mandatory Health Maintenance Organization (HMO) enrollment on prenatal care use, smoking and birth weight for Medicaid-covered pregnant women. The study compares deliveries in Ohio among a treatment group living in an area with mandatory enrollment and a control group living in an area with voluntary enrollment. Study data draws from Medicaid-covered deliveries to 24,799 non-Hispanic white women with no college education. The researchers recorded information on first trimester care, last trimester or no care, adequate prenatal care, inadequate prenatal care, smoking during pregnancy and birth weight.

Key Findings:

  • Receipt of early prenatal care increased by 3.5 percentage points within the mandatory HMO enrollment areas
  • Smoking during pregnancy decreased among the mandatory HMO enrollment areas by 7 percentage points as compared with no change among the voluntary enrollment areas
  • There was no significant effect on birth weight within the mandatory enrollment areas for either group.