Do Maternity Care Coordination Services Encourage Use of Behavioral Health Treatment among Pregnant Women on Medicaid?

OBJECTIVE: Maternity care coordination (MCC) may provide an opportunity to enhance access to behavioral health treatment services. However, this relationship has not been examined extensively in the empirical literature. This study examines the effect of MCC on use of behavioral health services among perinatal women.

METHODS: Medicaid claims data from October 2008 to September 2010 were analyzed using linear fixed effects models to investigate the effects of receipt of MCC services on mental health and substance use-related service use among Medicaid-eligible pregnant and postpartum women in North Carolina (n = 7,406).

RESULTS: Receipt of MCC is associated with a 20% relative increase in the contemporaneous use of any mental health treatment (within-person change in probability of any mental health visit 0.5% [95% CI, 0.1%-1.0%], or an increase from 8.3% to 8.8%); MCC in the prior month is associated with a 34% relative increase in the number of mental health visits among women who receive MCC (within-person change in the number of visits received 1.7% [95 CI, 0.2%-3.3%], or from 0.44 to 0.46 mental health visits). No relationship was observed between MCC and Medicaid-funded substance use-related treatment services.

CONCLUSIONS: MCC may be an effective way to quickly address perinatal mental health needs and engage low-income women in mental health care. However, currently there may be a lost opportunity within MCC to increase access to substance use-related treatment. Future studies should examine how MCC improves access to mental health care such that the program's ability can be strengthened to identify women with substance use-related disorders and transition them into available care.