Medicaid is the largest payer for maternity care in the United States. Infant birth weight is a common measure of infant and maternal health and well-being. Infants weighing less than 2,500 grams at birth may experience serious and costly health problems and developmental delays.
Explore the percentage of live births that weighed less than 2,500 grams in each state. Lower rates are better on this measure.
The purple dashed line represents the median, or middle, of all values reported.
This measure reports state performance on the percentage of live births that weighed less than 2,500 grams in the state during the measurement year.
Pregnant women are at higher risk of a low birth weight baby if they have:
- Chronic health conditions, such as high blood pressure or diabetes
- Low weight gain during pregnancy
- High stress levels
- High-risk behaviors, such as drinking alcohol, smoking cigarettes, or using drugs
States voluntarily report on Live Births Weighing Less Than 2,500 Grams (LBW-CH) as part of the Core Set of Children's Health Care Quality Measures. Starting with the Federal Fiscal Year (FFY) 2019 reporting year, states had the option to have CMS calculate this measure using data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) Database. CMS calculates this measure for states that do not report the measure or report the measure but do not use Child Core Set specifications. The CDC WONDER Database includes state-submitted natality data that is compiled by the National Center for Health Statistics (NCHS). States that reported the measure using Core Set specifications also had the option to use the rate calculated by CMS using CDC WONDER data.
The included populations for Child Core Set measures can vary by state. For example, some states report a single combined rate for both the Medicaid and CHIP populations, but other states report separate rates for these populations. In addition, states may include beneficiaries in some delivery systems, but exclude other delivery systems. For example, a state may include beneficiaries who are enrolled in managed care, but exclude beneficiaries who are covered on a fee-for-service (FFS) basis. This variation in populations can affect measure performance and comparisons between states.
As a result of the change in the data source used for this measure for some states, rates for FFY 2019 and later are not comparable to rates reported for previous years.
Source: CMS used two data sources for reporting this measure for the 2020 Child Core Set. The two sources are Mathematica analysis of Medicaid and CHIP Program System (MACPro) reports for the Child Core Set FFY 2020 reporting cycle as of June 18, 2021 and the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data as of November 24, 2020; see 2020 Child and Adult Health Care Quality Measures. The notes below identify the data source for each state’s rate for FFY 2020. For more information on the Live Births Weighing Less Than 2,500 Grams (LBW-CH) measure, visit Child Health Care Quality Measures.
The term “states” includes the 50 states, the District of Columbia, and Puerto Rico.
For FFY 2020, some states calculated and reported a rate in MACPro for LBW-CH using Child Core Set specifications, based on Centers for Disease Control and Prevention 2020 specifications. The Child Core Set specifications include guidance for calculating this measure using state vital records. States may link vital records data to administrative claims data to determine payer source. Denominators are assumed to be the measure-eligible population for states that reported using Child Core Set specifications. Some states reported exclusions from the denominator, as noted in the state-specific comments. The following states calculated and reported the measure in MACPro using Core Set specifications: AL (CHIP), CA, DE, FL, IA, IN, LA, ME, MN, NC, OH, SC, TX, and WV. Additional context for these states is included in the state-specific comments.
For states that did not report the measure in MACPro using Child Core Set specifications, CMS calculated LBW-CH using natality data submitted by states and compiled by the National Center for Health Statistics (NCHS) in CDC WONDER. In addition, some states that reported the measure in MACPro using Child Core Set specifications chose to have CMS report the rate based on CDC WONDER data. The rates calculated using CDC WONDER data include resident live births in the state that met the measure eligibility requirements and had a Source of Payment for Delivery of “Medicaid” on the birth certificate. In some states, this group may include deliveries that were paid for by CHIP. Rates for the following states were calculated using CDC WONDER data: AK, AL (Medicaid), AR, AZ, CO, CT, DC, GA, HI, ID, IL, KS, KY, MA, MD, MI, MO, MS, MT, ND, NE, NH, NJ, NM, NV, NY, OK, OR, PA, PR, RI, SD, TN, UT, VA, VT, WA, WI, and WY.
The population for all state rates calculated using CDC WONDER data are reported as “Medicaid only” because these rates include births that had a Source of Payment for Delivery of “Medicaid” on the birth certificate. In some states, this group may include deliveries that were paid for by CHIP.
ACO = Accountable Care Organization; ADHD = Attention-Deficit/Hyperactivity Disorder; CCO = Coordinated Care Organization; CHIP = Children’s Health Insurance Program; CMS = Centers for Medicare & Medicaid Services; CPT = Current Procedural Terminology; CY = Calendar Year; ED = Emergency Department; EPSDT = Early and Periodic Screening, Diagnostic, and Treatment; EQRO = External Quality Review Organization; FFS = Fee for Service; FFY = Federal Fiscal Year; HCBS = Home- and Community-Based Services; HEDIS = Healthcare Effectiveness Data and Information Set; HMO = Health Maintenance Organization; ICD = International Classification of Diseases; LOINC = Logical Observation Identifiers Names and Codes; MACPro = Medicaid and CHIP Program System; MCO = Managed Care Organization; MMIS = Medicaid Management Information System; NCHS = National Center for Health Statistics; NCQA = National Committee for Quality Assurance; NR = Not Reported; PCCM = Primary Care Case Management; PCP = Primary Care Practitioner.