They found that expenditures associated with providing adequate prenatal care were small in comparison to the overall budget for mothers and newborns. Despite this finding, the authors concluded that prenatal care was a reasonable investment. Expenditures for mothers with inadequate prenatal care were lower ($1,455) and only marginally higher for their infants ($1,264). For mothers deemed to have adequate prenatal care (as defined for the Schramm study as beginning by the fourth month of pregnancy and consisting of at least eight prenatal visits), the average Medicaid expenditure was $1,580 for maternal care and $1,249 for infant care. Schramm, Land, and Dutton (1984), in a study evaluating the cost effectiveness of prenatal care, studied Medicaid prenatal care expenditures in Missouri for 1981-82. Several State-specific studies have examined Medicaid expenditures for obstetrical-related care. These estimates were derived from projections of Medicaid fees in various States, rather than from actual per-person expenditures, which were not readily available. This average consisted of $1,600 for hospital care, $500 for physician fees, $100 for pregnancy-related care, and $600 for non-pregnancy-related care. Rodgers (1986) estimated that Medicaid expenditures for women who delivered in 1987 would average $2,850. births are financed by Medicaid ( Alan Guttmacher Institute, 1987).
According to AGI, 17 percent of total U.S. The proportions of total births that were covered by Medicaid ranged from an estimated 3.1 percent in Alaska to 24.3 percent in California ( Kenney, Torres, Dittes et al., 1986). These ranged from a low of $1,310 in Louisiana to a high of $3,520 in Tennessee. Their analysis also found that in 1984 Medicaid covered only 43 percent of women of childbearing age whose annual family income was less than $5,000 and 31 percent of those with incomes between $5,000 and $9,999.ĪGI estimated that average Medicaid expenditures per delivery for obstetrical care were $2,200 during the period 1984-85. Based on data from the 1984 Current Population Survey, Gold and Kenny (1985) of AGI report that 9 percent of women of childbearing age receive publicly funded support through Medicaid. The Alan Guttmacher Institute (AGI) has conducted a number of studies on the role of the Medicaid program in the financing of pregnancy and infant care. Information from this analysis may be useful in current policy debates on financing of cost-effective health services for low-income pregnant women and infants. This study complements previously analyzed aggregate, cross-sectional Medicaid data on services related to pregnancy and infant care by analyzing person-based data. We divided services associated with these deliveries into three periods: prenatal (January 1983 through the date preceding delivery admission) delivery hospitalization and post-delivery (date following delivery hospitalization discharge through October 31, 1984). In this study, Medicaid-financed deliveries from California, Georgia, and Michigan for the month of October 1983 were identified, and health services expenditure measures were developed and analyzed. The Tape-to-Tape project contains unique, person-based information on all services covered by Medicaid since 1980 in several States. Information presented in this article is from the Medicaid Tape-to-Tape project ( Health Care Financing Administration, 1983-84).
In addition to a lack of information on expenditures, relatively little has been known about the actual number of women and infants who receive Medicaid services and the types of Medicaid services they receive. A lack of uniform reporting systems across States has hindered efforts to perform comparative analyses of Medicaid expenditures for pregnancy and infant care. The Medicaid program is the Nation's primary source of financing medical care for low-income women and their children.
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