The Impact of Expanded Reimbursements for Home Visiting Services on Families' Social Determinants of Health

• In Event: Lightning Session: Family and Child Policy & Population and Migration Issues

Abstract

Michigan’s Maternal Infant Health Program (MIHP) is a statewide Medicaid supported home visiting program that aims to improve the health and wellness of Medicaid-eligible families during pregnancy and infancy. This study, conducted in collaboration with the Michigan Department of Health and Human Services, sought to determine whether the state could better serve families with high levels of need for basic services by expanding the list of billable services for which MIHP providers could be reimbursed. The study involved 59 MIHP agencies across the state. Half of the participating agencies were randomly assigned to a treatment group that was able to bill for several additional services including: a) additional visit time, b) an additional home visit, c) care coordination activities, and d) a discharge visit. The other half of the agencies were assigned to a control group and were only able to bill for a discharge visit.  

Using survey data from families and home visitors at discharge (over 1,700 respondents), the evaluation explored how the enhanced MIHP services impacted social determinants of health, health equity and other outcomes for families. The evaluation also examined the impact of the program on home visiting service providers. Results demonstrate that the expanded billing approach led to a range of positive outcomes including positive impacts on families’ self-reported social determinants of health (food security, financial security and housing stability). Impacts were particularly strong among Black families, families experiencing their first pregnancy, and families being served by independent freestanding agencies (as opposed to county health departments or health systems). The study team is currently conducting analyses of Medicaid claims data to examine the impact of the program on health care utilization including prenatal visits, post-partum visits, and well-child visits. These findings will be included in the presentation.  

 

Author

• Zaiyi Jiang, University of Michigan Ann Arbor
  Presenting Author