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The Latest Research, Commentary, And News From Health Affairs

Wednesday, February 24, 2021
Dear John,

Welcome to today’s newsletter. We’ll be focusing on a South Carolina Medicaid rule change that had significant implications for women’s postpartum health.
Vital Directions for Health and Health Care

Vital Directions for Health & Health Care: Priorities for 2021 virtual briefing, hosted by the National Academy of Medicine and Health Affairs, will discuss a set of issues with a particularly compelling need for attention to help ensure improved health and health care for all Americans. Hear an expert panel provide stakeholder perspectives on the top priorities for the new presidential administration and nation.
Postpartum LARC Trends in South Carolina & Beyond
Pregnancies shortly after childbirth are common, but many of these pregnancies are unintended. In fact, unintended pregnancies make up close to half of all pregnancies in the US. The availability and cost of contraception critically influences pregnancy determinants.

When family planning, immediate postpartum placement of long-acting reversible contraception (LARC) is an option for many new parents. But this method is not cheap. While the Affordable Care Act contraceptive coverage requirement decreased out-of-pocket spending on contraception and increased use of LARC for privately insured women, many women enrolled in Medicaid struggle to afford LARC.

In 2012, South Carolina’s Medicaid program began paying for LARC separately from the global maternity payment with the goal of increasing the availability of postpartum LARC.

In an article featured in the February edition of Health Affairs, Maria W. Steenland and coauthors found that South Carolina’s policy was associated with a significant overall increase in the use of highly effective contraceptive methods for postpartum adolescents, despite uneven availability among providers.

LARC utilization trends are important for providers, especially during the COVID-19 pandemic. In a recent blog post, Steenland and coauthors examine the implications of the COVID-19 pandemic on postpartum LARC. “To maintain contraceptive choice during the pandemic, hospitals must find solutions to ongoing implementation challenges, including provider training, device supply management, and billing changes,” they argue.  

Today we also turn to the issue of diversity in genomic databases in our Elevating Voices series for Black History Month. In a May 2018 article, Latrice G. Landry and coauthors examine the populations included in genomic studies whose data were available in two public databases and find significantly fewer studies of African, Latin American, and Asian ancestral populations in comparison to European populations.


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