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Prenatal and Postpartum Care: Postpartum Care


DOMAIN: Wellness and Prevention

Medicaid is the largest payer for maternity care in the United States. The program has an important role to play in improving maternal and perinatal health outcomes. Timely postpartum visits provide an opportunity to assess a woman’s physical recovery from pregnancy and childbirth.

Postpartum visits provide an opportunity to address:

  • Chronic health conditions, such as diabetes and hypertension
  • Mental health status, including postpartum depression
  • Family planning, including contraception and inter-conception counseling

Explore the percentage of women delivering a live birth who had a timely postpartum care visit in each state. Higher 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 deliveries of live births on or between October 8 of the year prior to the measurement year and October 7 of the measurement year with a postpartum visit on or between 7 and 84 days after delivery.

States voluntarily report on Prenatal & Postpartum Care: Postpartum Care (PPC-AD) as part of the Core Set of Adult Health Care Quality Measures. These data show performance rates for states that voluntarily reported the measure using Adult Core Set measure specifications.

The included populations and calculation methods for Adult Core Set measures can vary by state.  For example, some states include populations in certain programs, such as beneficiaries covered by Medicaid, but exclude beneficiaries in other programs, such as those dually eligible for Medicare and Medicaid. 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. States can also choose to calculate this measure using the administrative or hybrid method. This variation in populations and calculation methods can affect measure performance and comparisons between states.

Specifications for this measure changed substantially for Federal Fiscal Year (FFY) 2020 and rates are not comparable with rates reported for previous years.

Source: Mathematica analysis of Medicaid and CHIP Program System (MACPro) reports for the Adult Core Set FFY 2020 reporting cycle as of June 18, 2021; see 2020 Child and Adult Health Care Quality Measures. For more information on the Postpartum Care (PPC-AD) measure, visit Adult Health Care Quality Measures.

Notes:

The term “states” includes the 50 states, the District of Columbia, and Puerto Rico. The following states did not report data to the Centers for Medicare & Medicaid Services (CMS) for this measure: AK, AR, AZ, CO, IA, ID, ME, MN, MT, ND, NE, NY, and OR. The following states reported the measure to CMS, but did not use Adult Core Set specifications to calculate the measure: MN and OR.

The Adult Core Set specifications include guidance for calculating this measure using the administrative method or the hybrid method. The hybrid method uses a combination of administrative and medical records data to identify services included in the numerator or to determine exclusions from the denominator based on diagnoses or other criteria. Unless otherwise specified, administrative data sources are the state’s Medicaid Management Information System (MMIS) and/or data submitted by managed care plans; medical record data sources are paper and/or electronic health records.

Unless otherwise specified:

  • States used Adult Core Set specifications, based on National Committee for Quality Assurance (NCQA) 2020 specifications.
  • Denominators are assumed to be the measure-eligible population for states using the administrative method; states using the hybrid method often reported the sample size for the medical chart review rather than the measure-eligible population. Some states reported exclusions from the denominator, as noted in the state-specific comments.
  • The measurement period for this measure was October 2018 to October 2019. GA reported data for CY 2018; IN reported data for November 2018 to November 2019; and PR reported data for CY 2019.

ACO = Accountable Care Organization; AHRQ = Agency for Healthcare Research and Quality; CCO = Coordinated Care Organization; CHIP = Children’s Health Insurance Program; CMS = Centers for Medicare & Medicaid Services; CMO = Care Management Organization; CY = Calendar Year; ED = Emergency Department; EHR = Electronic Health Record; 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; NCQA = National Committee for Quality Assurance; NR = Not Reported; PCCM = Primary Care Case Management; PCP = Primary Care Practitioner.