Provision of Immediate Postpartum Long-Acting Reversible Contraceptives Before and After Wisconsin Medicaid's Payment Change

ObjectivesWe aimed to estimate the association between Medicaid unbundling of payment for long-acting reversible contraceptives (LARC) from global delivery fee and immediate postpartum (IPP) LARC provision, in a state outside select group early-adopters. We also examine potential moderating roles hospital academic affiliation Catholic status on IPP provision.MethodsWe used pre–post design provision. observed Medicaid-covered childbirth deliveries Wisconsin hospitals January 2016 December 2017 (n = 45,200) State Inpatient Database Agency Healthcare Research Quality's Cost Utilization Project. conducted multivariate regressions using generalized linear mixed models.ResultsFrom 2017, provision increased 0.28% 0.44% (p .003). In our adjusted model, was 1.55 times more likely post–period versus pre-period (95% confidence interval, 1.12–2.13). Both before after unbundling, significantly common nonacademic settings exceedingly rare institutions.ConclusionsIn contrast with many early adopting states, this later state, Medicaid's did not meaningfully change rates These results indicate that characteristics are strong correlates access suggest need interventions—perhaps inpatient setting—to ensure patients can desired contraceptive methods promptly postpartum.