How value-based care with provider enablement improves maternal and infant outcomes in Medicaid.

Objectives: Medicaid holds significant responsibility for improving maternal and infant health in the US. Utilizing value-based care (VBC) that offers additional support to providers is one strategy by which the Medicaid system can improve these outcomes. In this analysis, we examined a Medicaid managed care plan's incentive-only VBC program, which is supported by a provider enablement team to assist care providers in meeting program goals.

Study design: Cross-sectional analysis of deliveries occurring between July 2020 and June 2022 from Elevance Health-affiliated Medicaid managed care plans operating in 16 states.

Methods: This study primarily relied on medical claims data to compare maternal, infant, and cost outcomes in Medicaid members with a care provider participating in a supported VBC program vs those with a care provider not participating in supported VBC. A propensity-balanced multivariable regression model was used to estimate the impact of participation vs nonparticipation in supported VBC on delivery, cost, and quality outcomes.

Results: Members with a care provider supported in the VBC program had significantly lower neonatal intensive care unit (NICU) lengths of stay, preterm births, and low birth weights; significantly better timeliness and adequacy of prenatal care rates; and significantly lower birth costs, NICU costs, and maternal and infant costs in the first year after birth.

Conclusions: These results provide insight into how payers and care providers can partner to improve maternal and infant outcomes among Medicaid members and subsequently experience cost savings.