Managed Care Mandates and Birth Outcomes: Who Benefits and Does the Model Matter

The 2010 health reform seeks to expand health coverage to 30 million people and many will enroll in managed care plans. We exploit Medicaid manage care mandates in California to examine the effect of managed care on prenatal care access and birth and pregnancy outcomes. There is no improvement for the extremely disadvantaged, but access and birth outcomes improves for the moderately disadvantaged. The results suggest that a managed care option may be key for improving access to prenatal care and birth outcomes as health care is expanded to the near poor under the health care reform. * The authors would like to thank Brian Cadena, Alain de Janvry, Terra McKinnish, Elisabeth Sadoulet, and anonomous reviewers for their helpful comments and input. We would also thank the California Policy Research Center for its financial support as well as Marcine Craine and Jim Kleine from the California Department of Health Services for their help with the programmatic details about the managed care mandates and data. All mistakes are solely those of the authors, and the usual disclaimers apply. † The corresponding author’s contact information is: University of Colorado at Boulder, 483 UCB, Boulder, CO, 80309 (email: [email protected]; tel. 303-492-0237).