The Effects of Medicaid Policy Interventions on Racial Equity in Severe Maternal Morbidity

Not Applicable

Recruiting

• Conditions: Maternal Death; Severe Maternal Morbidity

• Registration Number: NCT05678699
• Lead Sponsor: University of Pittsburgh

Brief Summary

The goal of this study is to learn about the effects of structural inventions, such as equity-focused Medicaid polices, on severe maternal morbidity (SMM) and mortality and maternal health. The main questions it aims to answer are:

1. What is the effect of Medicaid healthcare quality interventions on SMM?

2. What is the effect of Medicaid healthcare quality interventions + doula care?

3. What are Medicaid beneficiaries' experiences in receiving services and the potential impact of integration of doula services and equity practices?

Participants will be asked to describe experiences as a result of structural interventions and focused Medicaid policies.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2022-10-26
• Study First Submitted QC: 2022-12-22
• Study Start: 2023-01-03
• Study First Posted: 2023-01-10
• Status Verified: 2025-07
• Last Update Submitted: 2025-07-17
• Last Update Posted: 2025-07-22
• Primary Completion: 2027-06
• Study Completion: 2027-06-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 10000000

Inclusion Criteria

• Pregnant and postpartum Medicaid beneficiaries across the US

Qualitative:

• Medicaid beneficiaries who self-identify as Black and/or live in PA Health Equity Zones
• Doulas who provide care to Medicaid beneficiaries in Pennsylvania
• Medicaid Managed Care Organization (MCO) administrators in Pennsylvania. Severe maternal morbidity and mortality outcomes will be assessed in healthcare records and for these quantitative outcomes, patients will not be recruited individually

Exclusion Criteria

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: FACTORIAL

Primary Outcome Measures

Name	Time	Method
Severe maternal morbidity (SMM)	20 weeks gestation through 42 days postpartum	SMM rate based on the Centers for Disease Control algorithm

Secondary Outcome Measures

Name	Time	Method
Medicaid managed care administrator perspectives on policy interventions	Year 3	Qualitative self report of perspectives
Follow up for chronic conditions	43 days through 1 year after delivery	Percent of persons who receive guideline concordant care for depression, substance use disorders, immunizations, and screening and referral for social determinants of health
Provision of evidence care in pregnancy and postpartum	During pregnancy and postpartum up to 1 year	Percent of Medicaid patients among each provider who receive screening and follow up for depression, treatment for substance use disorders, perinatal immunizations, and screening and referral for social determinants of health
All cause mortality	Delivery date through one year after delivery	Binary indicator of mortality based on Social Security Administration records

Trial Locations

Locations (1)

University of Pittsburgh School of Public Health; 🇺🇸 Pittsburgh, Pennsylvania, United States