Impacts of Enhanced Prenatal Care on Cost, Substance Use Engagement and Foster Care Outcomes among Pregnant Women with Substance Use Disorder

Impacts of Enhanced Prenatal Care on Cost, Substance Use Engagement and Foster Care Outcomes among Pregnant Women with Substance Use Disorder Menolly Kaufman MPH, Jenny Grunditz MS, Stephanie Renfro MS, John McConnell PhD Background: Pregnant women with substance use disorders represent a unique challenge to the health care system. In the absence of treatment, their children are at risk for neonatal abstinence syndrome, a condition that is correlated with poor childhood outcomes and high health care costs. However, these women may be reluctant to engage in traditional treatment out of a fear of legal repercussions, potentially leading to placement of their children in foster care. In response to these challenges, one of Oregon’s Coordinated Care Organization created a center of excellence model – Project Nurture - that integrated maternity care and substance use treatment at three sites in the Portland Metro area. Objectives: We aim to assess if participants receiving care through Project Nurture site exhibit (1) lower hospital expenditures (2) increased substance use treatment engagement and (3) decreased foster care placement within the first year of birth. Methods: We will conduct difference-in-difference analysis to estimate the impact of Project Nurture, comparing outcomes in 2012-2014 to outcomes in 2016-2017, after the Project Nurture implementation. Our treatment group consists of women receiving any prenatal care from a Project Nurture provider before birth. They will be compared to a matched cohort who do not receive care through Project Nurture. We will link Medicaid claims, vital records and foster care data for our analyses