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Prenatal and Postpartum Care: Postpartum Care


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 during the measurement year with a postpartum care visit on or between 21 and 56 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.

Source: Mathematica analysis of Medicaid and CHIP Program System (MACPro) reports for the Adult Core Set Federal Fiscal Year (FFY) 2019 reporting cycle as of May 31, 2020; see 2019 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 following states did not report data to the Centers for Medicare & Medicaid Services (CMS) for this measure: AK, AR, AZ, GA, IA, ID, ME, MT, ND, NE, SD, and VT.

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) 2019 specifications. The following state used NCQA 2018 specifications: OR.
  • 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 November 1, 2017 to November 30, 2018. IN reported data for CY 2018.

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; 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.