The Impact of the North Carolina Pregnancy Medical Home Program on Rates of Primary Cesarean Delivery among Medicaid Beneficiaries: 2011-2013

Objective: To determine if the implementation of the Pregnancy Medical Home program in North Carolina corresponded with changes in the primary cesarean rate among Medicaid beneficiaries. Methods: NC Birth Certificate Data from 2011 and 2013 were analyzed using logistic regression to compare differences in Medicaid and non-Medicaid populations. The outcome variable was primary cesarean delivery and the exposure of interest was payment status. Results: The results suggest that there was a statistically significant decrease in primary cesarean deliveries unique to Medicaid beneficiaries from 2011 to 2013. Conclusion: A decrease in primary cesarean deliveries occurred among Medicaid recipients corresponding with the implementation of the PMH program. Further studies are needed to determine the specific impact of the PMH program on cesarean deliveries.Master of Public Healt