Maternal and Child Health Journal

, Volume 17, Issue 8, pp 1518–1525 | Cite as

Racial Disparities in Economic and Clinical Outcomes of Pregnancy Among Medicaid Recipients

  • Shun Zhang
  • Kathryn Cardarelli
  • Ruth Shim
  • Jiali Ye
  • Karla L. Booker
  • George Rust
Article

Abstract

To explore racial-ethnic disparities in adverse pregnancy outcomes among Medicaid recipients, and to estimate excess Medicaid costs associated with the disparities. Cross-sectional study of adverse pregnancy outcomes and Medicaid payments using data from Medicaid Analytic eXtract files on all Medicaid enrollees in fourteen southern states. Compared to other racial and ethnic groups, African American women tended to be younger, more likely to have a Cesarean section, to stay longer in the hospital and to incur higher Medicaid costs. African-American women were also more likely to experience preeclampsia, placental abruption, preterm birth, small birth size for gestational age, and fetal death/stillbirth. Eliminating racial disparities in adverse pregnancy outcomes (not counting infant costs), could generate Medicaid cost savings of $114 to $214 million per year in these 14 states. Despite having the same insurance coverage and meeting the same poverty guidelines for Medicaid eligibility, African American women have a higher rate of adverse pregnancy outcomes than White or Hispanic women. Racial disparities in adverse pregnancy outcomes not only represent potentially preventable human suffering, but also avoidable economic costs. There is a significant financial return-on-investment opportunity tied to eliminating racial disparities in birth outcomes. With the Affordable Care Act expansion of Medicaid coverage for the year 2014, Medicaid could be powerful public health tool for improving pregnancy outcomes.

Keywords

Disparities Medicaid Economic burden Adverse maternal-child health outcomes and eliminating disparities 

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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Shun Zhang
    • 1
  • Kathryn Cardarelli
    • 2
  • Ruth Shim
    • 3
  • Jiali Ye
    • 1
  • Karla L. Booker
    • 4
  • George Rust
    • 1
  1. 1.National Center for Primary Care at Morehouse School of MedicineAtlantaUSA
  2. 2.Department of EpidemiologyUniversity of North Texas Health Science CenterFort WorthUSA
  3. 3.Department of PsychiatryMorehouse School of MedicineAtlantaUSA
  4. 4.Division of Maternal-Child Health, Department of Family MedicineMorehouse School of MedicineAtlantaUSA

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