Public Insurance Payment Mandates and Non-Physician Provider

• In Event: Advancing Racial Equity in Health and Social Policy: Evidence from Programs, Providers, and Policy Design

Abstract

Public insurance reimbursement policies play a key role in shaping healthcare markets. Unlike competitive markets, where prices regulate supply and demand, healthcare financing is largely mediated through insurance, making insurer reimbursement choices influential in the broader healthcare market. This study examines the impact of mandated public insurance reimbursements for Certified Nurse-Midwives (CNMs), focusing on the 1980 federal Medicaid mandate requiring states to reimburse CNM services. We find that the mandate led to a 42\% increase in midwife-attended deliveries. We also find a geographic expansion of midwife deliveries, suggesting that financial incentives affect both provider supply and service distribution. Despite these shifts, we observe little change in health outcomes, indicating that CNMs deliver safe care comparable to physicians. These results highlight how reimbursement mandates can reshape healthcare labor markets and expand access without compromising healthcare safety.

Authors

• Yu-Ting Huang, Georgia State University
  Presenting Author

• Lauren Velasco, Georgia State University
  Non-Presenting Co-Author

• Olanrewaju Yusuff, Georgia State University
  Non-Presenting Co-Author