Medicaid Strategies to Promote Increased Access to Long-Acting Reversible Contraception (LARC)
Unplanned pregnancies can present a tremendous challenge for many women, healthcare payers and the community, and are associated with a number of negative health outcomes, such as delayed prenatal care and premature births. Efforts like the Centers for Medicare and Medicaid Services’ (CMS) recent guidance and the Collaborative Improvement & Innovation Network to Reduce Infant Mortality (IM CoIIN) have improved maternal and infant health outcomes, while also highlighting the $10 billion cost burden Medicaid expends on unplanned births.
To reduce and avoid unplanned pregnancies, states are turning to Medicaid to increase access to long-acting reversible contraception (LARC). LARC implants and devices are safe and effective options for women to avoid unplanned pregnancies. Studies show intrauterine devices (IUDs), the most common form of LARC, have a less than one percent failure rate with one year of typical use. Despite their effectiveness, LARC remains underutilized, with only 10 percent of women of reproductive age reporting use. Some of the most significant barriers to greater LARC use are the high upfront costs to stock these devices, which prevent providers from offering same-day LARC insertion, and inadequate reimbursement strategies for providers.
States are using several Medicaid payment strategies to improve women’s access to LARC. Some of the most noted efforts include policies that enable immediate, postpartum LARC insertion, and payment strategies that reduce the burden for doctors seeking to stock LARC devices in outpatient settings.
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