Updated Pennsylvania policy makes birth control accessible to mothers
November 22, 2016 12:18 AM
A copper-based ParaGard IUD, left, and a hormone-releasing Mirena IUD.
By Courtney Linder / Pittsburgh Post-Gazette
Under Medicaid’s current framework, hospitals don’t have financial incentive to stock reversible forms of birth control for recent mothers. So, even if a mother requests an intrauterine device or an implant as a part of her delivery services, she may be denied.
That changes Dec. 1 when the Pennsylvania Department of Human Services enacts a new policy to make long-acting reversible contraception protections available to women after delivery.
Currently, hospitals receive bundled payments for labor and delivery services, according to a DHS press release. Since insurers typically pay a lump sum intended to cover all costs of childbirth, hospitals are paid the same amount whether they offer postpartum birth control or not, confirmed DHS Deputy Press Secretary Rachel Kostelac.
Under the new policy, Pennsylvania’s Medicaid fee-for-service program will not only pay hospitals for bundled services, but will separately reimburse providers for inserting contraception devices. These include the IUD, a T-shaped piece of plastic placed into the uterus, and the subdermal implant, a small rod placed under the skin of the upper arm.
Additionally, the new policy will devote federal funds to training physicians and health care providers in implanting these devices as a form of postpartum pregnancy prevention.
“This will decrease unplanned pregnancies in the commonwealth and allow providers to be more comfortable with educating their patients on [long-acting reversible contraction], in general,” said Loren K. Robinson, Pennsylvania Department of Health Deputy Secretary for Health Promotion and Disease Prevention, in an interview. “The more comfortable providers are, the more comfortable they are suggesting them to their patients.”
Data from the 2010 Census indicates 51 percent of U.S. births were paid for by Medicare, according to a February 2015 study conducted by the Guttmacher Institute, a New York City-based family planning research firm. Of those publicly funded births, each cost an average of $12,770 in prenatal care, labor and delivery. Half of those births were unplanned.
By comparison, the average cost of an IUD ranges between $500-$900 without insurance, according to Planned Parenthood. Implanon, the birth control implant, costs up to $800 and may cost up to $300 in removal fees.
Each form of these devices lasts several years — the IUD protects against pregnancy for five to 12 years, depending upon type, and the hormone-releasing implant for three years — allowing mothers to space their children out or prevent pregnancy altogether.
“This is a public health issue that crosses both economic and social lines. Back-to-back pregnancies are an increased risk to maternal health outcomes,” DOH Secretary Dr. Karen Murphy noted in press release.
By removing high upfront costs, the DOH expects its new policy to increase usage of these devices by up to 6 percent.
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