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Medical interventions among pregnant women in fee-for-service and managed care insurance: a propensity score analysis

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This paper extends earlier research on the effect of managed care on the receipt of four medical interventions for pregnant women: ultrasound, induction/stimulation of birth, electronic fetal monitor, and Caesarean delivery. Propensity score methods are used to account for sample selection issues regarding insurance choice. Managed care enrollees are more likely to receive an ultrasound, which may be indicative of receiving better prenatal care. Managed care plans reduce the rate of Caesarean deliveries, but such limitations may be beneficial given the substantial medical evidence that Caesarean deliveries are over-utilized. The results indicate that insurance coverage does influence treatment intensity, but that utilization controls and provider financial incentives do not adversely affect care for pregnant women.

Document Type: Research Article


Affiliations: 1: Department of Economics and Finance, West Chester University, West Chester, PA 19383, USA 2: Department of Mental Health Law and Policy, FMHI, MHC 2739, University of South Florida, 13301 Bruce B. Downs Blvd, Tampa, FL 33612, USA 3: Department of Economics, SUNY – Binghamton, Binghamton, NY 13902, USA

Publication date: July 20, 2006

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