The Effects of the Medicaid Continuous Coverage Requirement during the Public Health Emergency on Postpartum Coverage and Maternal and Infant Care after Childbirth

突发公共卫生事件期间医疗补助持续覆盖要求对产后覆盖和产后母婴护理的影响

• 批准号: 10643130
• 负责人: Erica L Eliason
• 金额: $ 12.05万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10643130
• 关键词: Address; Affect; American; Award; Birth; Black Populations; COVID-19; COVID-19 mortality; COVID-19 pandemic; COVID-19 pandemic effects; Caring; Childbirth; Clinical; Contraceptive methods; Coronavirus; Data; Data Analyses; Databases; Department chair; Developed Countries; Development; Discipline of obstetrics; Disparity; Eligibility Determination; Emergency Medicine; Epidemiology; Ethnic Origin; Family; Freezing; Future; Goals; Gynecology; Health; Health Insurance; Health Policy; Health Services; Health Services Accessibility; Healthcare; Healthcare promotion; Hispanic Populations; Income; Individual; Infant; Infant Care; Infant Health; Insurance; Link; Low Income Population; Low income; Maternal Health; Maternal Health Services; Maternal Mortality; Maternal and Child Health; Measures; Medicaid; Medicaid eligibility; Medicine; Mentors; Mentorship; Methods; National Institute of Child Health and Human Development; Outcome; Pediatrics; Persons; Phase; Policies; Population Study; Postpartum Depression; Postpartum Period; Pregnancy; Pregnancy loss; Qualifying; Race; Research; Research Assistant; Research Personnel; Research Priority; Research Project Grants; Rhode Island; Risk; Severities; Techniques; Testing; Time; Training; United States; Universities; Variant; career; career development; demographics; disparity reduction; ethnic disparity; experience; federal poverty level; health care availability; health care disparity; health care service; health disparity; health outcome disparity; improved; infant outcome; interest; maternal morbidity; pandemic disease; people of color; poor health outcome; postpartum care; postpartum health; prevent; professor; public health emergency; racial disparity; response; skills; treatment effect

PROJECT SUMMARY/ABSTRACT Career Goal: My long-time career goal is to become an independent investigator studying the effects of health care policies on access and use of maternal and infant health care services among low-income populations. With additional skills in claims data, subject matter expertise, and causal inference methods, I plan to build a career focused on generating evidence to improve maternal and child health outcomes and reduce disparities in the United States. Career Development: I will pursue the following training aims during the mentored (K99) phase of the award: (1) clinical maternal and infant health content expertise; (2) claims data analysis skills; (3) advanced causal methods, and; (4) professional development. Research Project: Extending postpartum Medicaid has the potential to address poor maternal health in the United States, with additional implications for infant care use and health.1 Approximately 63% of maternal deaths in the U.S. occur postpartum, and more than half are considered to be preventable.2 However, despite high postpartum healthcare needs, pregnancy- related Medicaid ends after 60 days postpartum. Medicaid pays for almost half of all births in the US and disproportionately covers births to the low-income population and people of color.3–5 There has recently been increased interest in postpartum Medicaid, including an American Rescue Plan (ARP) option to extend Medicaid one-year postpartum.6 Prior to this, the March 2020 Families First Coronavirus Response Act (FFCRA) prevented Medicaid disenrollment during the pandemic, thereby extending postpartum Medicaid eligibility, which can inform current postpartum Medicaid policies under consideration. Using the Rhode Island All-Payer claims data, this proposal's Specific Aims are: K99/1) To evaluate the effects of the FFCRA on coverage and maternal and infant care in the postpartum period, R00/2) To evaluate the heterogeneous effects of the FFCRA on outcomes by race and ethnicity, R00/3) To evaluate how the COVID-19 pandemic affected the effects of extended postpartum Medicaid eligibility on care use. Mentorship: I have assembled a highly accomplished team of experts at Brown University to provide mentorship and guidance as I transition to research independence, comprised of Dr. Trivedi, Professor in the Department of Health Services, Policy and Practice and Department of Medicine; Dr. Steenland, Research Assistant Professor of Population Studies in the Population Studies and Training Center; Dr. Vivier, Professor of Health Services, Policy and Practice and Professor of Pediatrics and Emergency Medicine; Dr. Wilson, Professor and Chair of the Department of Health Services, Policy and Practice, and Professor of Medicine; Dr. Savitz, Professor of Epidemiology and Professor of Obstetrics and Gynecology and Pediatrics; and Dr. Tuuli, Chace-Joukowsky Professor and Chair of Obstetrics & Gynecology. Future Directions: The training and research in this proposal will provide me with a unique set of expertise and skills to prepare me to reach research independence and submit an R01 application to examine the effects of state variation in postpartum Medicaid policies using claims data.

项目摘要/摘要 职业目标：我的长期职业目标是成为研究健康影响的独立调查员 低收入人群中有关母校和婴儿医疗保健服务的访问和使用政策。 凭借索赔数据，主题专业知识和因果推理方法的其他技能，我计划建立一个 专注于创造证据以改善产妇和儿童健康成果并减少分销 在美国。职业发展：我将在此问题期间追求以下培训目标（K99） 奖励阶段：（1）临床物物和婴儿健康内容专业知识； （2）索赔数据分析技能； （3） 高级因果方法，并且； （4）专业发展。研究项目：延长产后 医疗补助有可能解决美国的母子健康状况不佳，对 婴儿护理和健康。1美国大约有63％的遗中死亡发生，更多 2但是，渴望产后医疗保健需求，怀孕 - 相关医疗补助产后60天后结束。医疗补助在美国几乎一半的出生付款， 不成比例地涵盖了低收入人群和有色人种的出生。3-5最近有 增加对产后医疗补助的兴趣，包括美国救援计划（ARP）的选择 医疗补助为期一年的产后。6在此之前，《 2020年3月家庭》第一冠状病毒反应法 （FFCRA）在大流行期间阻止了医疗补助的剥夺，从而延长了产后医疗补助 资格，可以告知当前正在考虑的产后医疗补助政策。使用罗德岛 全付款人索赔数据，该提案的具体目的是：K99/1）评估FFCRA的影响 覆盖范围以及产后时期的母亲和婴儿护理，R00/2）评估异质效应 ffcra关于种族和种族结果的结果，r00/3）评估互联-19大流行如何影响 扩展产后医疗补助资格对护理使用的影响。指导：我聚集了一个高度 布朗大学有成熟的专家团队，在我过渡到 研究独立性，由卫生服务部，政策和政策系教授Trivedi博士组成 诊所和医学系； Steenland博士，研究助理人口研究助理教授 人口研究和培训中心； Vivier博士，卫生服务，政策和实践教授以及 儿科和急诊医学教授；威尔逊博士，卫生部教授兼主席 服务，政策和实践和医学教授； Savitz博士，流行病学教授兼教授 妇产科和儿科； Chace-Joukowsky教授兼主席Tuuli博士 产科和妇科。未来的方向：该提案中的培训和研究将为我提供 独特的专业知识和技能集，使我准备达到研究独立性并提交R01 使用索赔数据的应用程序，以检查产后医疗补助政策的状态变异的影响。