|Equation||(# pregnant women) x (% mothers getting assistance solely because of the program) x (Q: % avoided infant deaths due to the intervention) x ($ value per life saved)|
|Explanation||Enhanced prenatal care programs delivered through Medicaid provide non-clinical services that support maternal wellness and infant health during the prenatal period, such as care coordination, health education, risk assessment, psychosocial support, or nutritional counseling. These programs are delivered in a primary healthcare setting and provided by either a nurse or a social worker. Women are eligible for these programs during pregnancy, with some benefits continuing through the first twelve months postpartum. Participants typically receive program benefits for three to sixteen months, including both prenatal and postpartum services.
Number of pregnant women: Reported by program.
Percentage of women getting assistance solely because of the program: Estimated by Constellation Fund staff.
Q: Percentage of avoided infant death due to the intervention: [0.00067]. This is estimated by Constellation staff using the following formula:
In this formula, ES is the effect size from meta-analysis of prenatal care programs on infant mortality [-0.088] (WSIPP, 2017). The base percentage is [0.5%], which is the infant mortality rate in Minnesota (Minnesota Department of Health, 2017).
$ value per life saved: We estimate the value of a life based on a [$50,000] QALY. This value varies by the age and expected years of life of each participant. Thus, we compute total benefits of a program based on specific program data on participants age and discount the annual value to present value using Constellation’s standard discounting method.
|References||Arima, Y., Guthrie, B.L., Rhew, I.C., & De Roos, A.J. (2009). The impact of the First Steps prenatal care program on birth outcomes among women receiving Medicaid in Washington State. Health Policy (Amsterdam, Netherlands), 92(1), 49-54.
Buescher, P.A., Roth, M.S., Williams, D., & Goforth, C.M. (1991). An evaluation of the impact of maternity care coordination on Medicaid birth outcomes in North Carolina. American Journal of Public Health, 81(12), 1625-9.
Hillemeier, M.M., et al. (2015). Effects of maternity care coordination on pregnancy outcomes: propensity-weighted analyses. Maternal and Child Health Journal, 19(1), 121-7
Korenbrot, C., & Patterson, E. (1995). Evaluation of California’s Statewide Implementation of Enhanced Perinatal Services as Medicaid Benefits. Public Health Reports, 110(2), 125-133. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1382091/
Minnesota Compass (2010). https://www.mncompass.org/_pdfs/presentations/BlueCross_HealthInequities_10-10.pdf
Minnesota Department of Health (2017). Vital Statistics – Infant/Fetal Mortality. Minnesota Center for Health Statistics. Retrieved from: https://www.health.state.mn.us/data/mchs/vitalstats/infant.html
Washington State Institute of Public Policy – WSIPP (2017). Retrieved from http://www.wsipp.wa.gov/BenefitCost/Program/680