Impact of Medicaid Provider Incentives for Postpartum LARC Provision on Postpartum Contraceptive Use

To encourage provision of Long Acting Reversible Contraceptives (LARCs) immediately after childbirth (IPP-LARC), while the new mother is still in the hospital, 37 state Medicaid programs have now decoupled the LARC payment from the global payment for the childbirth episode. Early evaluations in South Carolina, the first state to make this policy change, found increases in IPP-LARC use but uneven uptake across the state's hospitals and geographic areas. This study will extend this work by examining changes in IPP-LARC use in five other early adopting states (MD, NY, RI, IA, and IL), with a focus on identifying hospital characteristics associated with uptake and exploring variation in use by mothers’ race, income and education. The project will also examine the policy's impact on post-partum use of effective methods of contraception more generally.