Pennsylvania Medicaid policy and rural hospital implementation of immediate postpartum contraception

Abstract

Objectives

This study aimed to assess the importance of Pennsylvania Medicaid immediate postpartum long-acting reversible contraception (IPLARC) reimbursement policy changes for hospital implementation of IPLARC by rurality.

Study design

We surveyed clinician leaders at 51 of 82 (62.2%) Pennsylvania hospitals with labor and delivery units in 2022, including 10 of 51 (19.6%) rural and 17 of 51 (33.3%) academic.

Results

Six years after Pennsylvania Medicaid began covering IPLARC outside the obstetrical care bundle, only 3 of 10 (30.0%) rural and 18 of 41 (43.9%) nonrural labor and delivery units had implemented IPLARC.

Conclusions

Fewer than half of delivering hospitals in Pennsylvania offered access to IPLARC, even after favorable Medicaid reimbursement policy changes. Nonrural hospitals are more likely to offer IPLARC than rural hospitals.