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Potential unintended pregnancies averted and cost savings associated with a revised Medicaid sterilization policy

Author(s): Borrero, S.; Zite, N.; Potter, J.E.; Trussell, James; Smith, K.

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Abstract: OBJECTIVE: Medicaid sterilization policy, which includes a mandatory 30-day waiting period between consent and the sterilization procedure, poses significant logistical barriers for many women who desire publicly-funded sterilization. Our goal was to estimate the number of unintended pregnancies and the associated costs resulting from unfulfilled sterilization requests due to Medicaid policy barriers. STUDY DESIGN: We constructed a cost effectiveness model from the health care payer perspective to determine the incremental cost over a 1-year time horizon of the current Medicaid sterilization policy compared to a hypothetical, revised policy in which women who desire a post-partum sterilization would face significantly reduced barriers. Probability estimates for potential outcomes in the model were based on published sources; costs of Medicaid-funded sterilizations and Medicaid-covered births were based on data from the Medicaid Statistical Information System and The Guttmacher Institute, respectively. RESULTS: With the implementation of a revised Medicaid sterilization policy, we estimated that the number of fulfilled sterilization requests would increase by 45%, from 53.3% of all women having their sterilization requests fulfilled to 77.5%. Annually, this increase could potentially lead to over 29,000 unintended pregnancies averted and $215 million saved. CONCLUSION: A revised Medicaid sterilization policy could potentially honor women's reproductive decisions, reduce the number of unintended pregnancies, and save a significant amount of public funds. IMPLICATION: Compared to the current federal Medicaid sterilization policy, a hypothetical, revised policy that reduces logistical barriers for women who desire publicly-funded, post-partum sterilization could potentially avert over 29,000 unintended pregnancies annually and therefore lead to a cost savings of $215 million each year.
Publication Date: 2013
Citation: Borrero, S, Zite, N, Potter, JE, Trussell, J, Smith, K. (2013). Potential unintended pregnancies averted and cost savings associated with a revised Medicaid sterilization policy. Contraception, 88 (691-696). doi:10.1016/j.contraception.2013.08.004
DOI: doi:10.1016/j.contraception.2013.08.004
ISSN: 0010-7824
Pages: 691-696
Type of Material: Journal Article
Journal/Proceeding Title: Contraception
Version: Author's manuscript

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