Funder: Aetna, Inc., the Aetna Foundation, and the Annie E. Casey Foundation

Author: Stacey Chazin and Roopa Mahadevan, Center for Health Care Strategies

April 2014 | Report


Medicaid is the nation’s predominant payer for obstetric services and the health insurer for one-third of U.S. children. Understanding where children and pregnant women enrolled in Medicaid or CHIP receive care — and the degree of access and quality at these sites — is critical for state Medicaid agencies to guide quality improvement efforts for these populations.

To explore these issues, the Center for Health Care Strategies (CHCS) examined the characteristics, quality of care, and quality improvement activities of Medicaid pediatric and obstetric practices in the fee-for-service or primary care case management delivery systems in three states: Arkansas, Iowa, and Pennsylvania. This report presents findings from the three-state analysis, which suggest certain populations, health services, and care settings that could benefit from Medicaid agency support. While drawn from a small sample of states with fee-for-service or primary care case management delivery systems, other state Medicaid agencies can consider how this analysis may be applied to an examination of their own delivery system performance. See the executive summary for key findings and takeaways from the study.