Maternal Health Equity in Medicaid Accountable Care Organizations: Early Lessons from the Massachusetts Experience

Laura B Attanasio; Kimberley H Geissler

doi:10.1089/heq.2023.0103

Maternal Health Equity in Medicaid Accountable Care Organizations: Early Lessons from the Massachusetts Experience

Health Equity. 2023 Sep 13;7(1):520-524. doi: 10.1089/heq.2023.0103. eCollection 2023.

Authors

Laura B Attanasio¹, Kimberley H Geissler¹

Affiliation

¹ Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA.

Abstract

There are substantial inequities by race and ethnicity in maternal health care utilization and health outcomes across the perinatal period. As Medicaid covers 42% of births nationally and almost two-thirds of births to Black birthing people, state Medicaid financing and delivery system reforms have substantial scope to impact these inequities. Twenty-one states have implemented Medicaid Accountable Care Organizations (ACOs) at some point since 2015. Using public documents and interviews with ACO administrators, we examine the implications of Massachusetts Medicaid ACOs, implemented in March 2018, for maternal health equity. Although these Medicaid ACOs have the potential to impact maternal health equity, they face many challenges in doing so. We review future steps within Massachusetts Medicaid ACOs and Medicaid programs more generally to incorporate policies that may better address racial and ethnic inequities.

Keywords: Accountable Care Organizations; Medicaid; health equity; maternal health.