Horvath Sarah, Guare Emma G, Ferguson Grace, Chuang Cynthia H
Penn State University Hershey Medical Center, Department of Obstetrics and Gynecology, Hershey, PA, United States.
Allegheny Health Network, Department of Obstetrics and Gynecology, Pittsburgh, PA, United States.
Contraception. 2025 Jun;146:110858. doi: 10.1016/j.contraception.2025.110858. Epub 2025 Feb 27.
This study aimed to assess the importance of Pennsylvania Medicaid immediate postpartum long-acting reversible contraception (IPLARC) reimbursement policy changes for hospital implementation of IPLARC by rurality.
We surveyed clinician leaders at 51 of 82 (62.2%) Pennsylvania hospitals with labor and delivery units in 2022, including 10 of 51 (19.6%) rural and 17 of 51 (33.3%) academic.
Six years after Pennsylvania Medicaid began covering IPLARC outside the obstetrical care bundle, only 3 of 10 (30.0%) rural and 18 of 41 (43.9%) nonrural labor and delivery units had implemented IPLARC.
Fewer than half of delivering hospitals in Pennsylvania offered access to IPLARC, even after favorable Medicaid reimbursement policy changes. Nonrural hospitals are more likely to offer IPLARC than rural hospitals.
本研究旨在评估宾夕法尼亚医疗补助计划产后即时长效可逆避孕（IPLARC）报销政策变化对农村地区医院实施IPLARC的重要性。
2022年，我们对宾夕法尼亚州82家设有产科病房的医院中的51家（62.2%）的临床医生负责人进行了调查，其中包括51家医院中的10家（19.6%）农村医院和51家医院中的17家（33.3%）学术医院。
在宾夕法尼亚医疗补助计划开始在产科护理套餐之外涵盖IPLARC六年之后，10家农村产科病房中只有3家（30.0%）实施了IPLARC，41家非农村产科病房中有18家（43.9%）实施了IPLARC。
即使在医疗补助报销政策有利变化之后，宾夕法尼亚州不到一半的分娩医院提供IPLARC服务。非农村医院比农村医院更有可能提供IPLARC服务。
