Bodas Mandar, Park Yoon Hong, Luo Qian Eric, Vichare Anushree
The George Washington University, DC, USA.
J Prim Care Community Health. 2025 Jan-Dec;16:21501319251356078. doi: 10.1177/21501319251356078. Epub 2025 Jul 31.
Community Health Centers (CHCs) care for nearly a third of all pregnant Medicaid enrollees. Given that Medicaid covers 41% of childbirths, CHCs play a critical role in ensuring pregnant enrollees' access to perinatal services. Despite their importance, little is known about the CHC workforce serving these patients. This study uses multi-state Medicaid claims data to analyze the providers caring for pregnant Medicaid enrollees at CHCs.
Our primary data source was the Transformed Medicaid Statistical Information System (T-MSIS) Analytical File (TAF), 2016 to 2021. We identified all pregnant and postpartum Medicaid enrollees that received care at CHCs and examined the workforce serving this population from the following specialties: Obstetricians and Gynecologists (OBGYNs), Nurse Practitioners (NPs), Family Physicians (FPs), and Physician Associates (PAs). We summarized the annual number of providers from each specialty and total number of pregnant and postpartum enrollees served per year. Since the study period overlapped with the COVID-19 pandemic, we also examined the provision of telehealth by this workforce.
The workforce serving pregnant Medicaid enrollees at CHCs each year grew 23% during the study period (22 027-28 668 providers), and that serving postpartum enrollees increased by 20% (25 655-32 026). Total annual number of NPs experienced faster growth than FPs for both pregnant (31% vs 17%) and postpartum enrollee care (27% vs 17%). OBGYN and PA counts remained relatively stable during the study period. The number of providers that served pregnant and postpartum Medicaid enrollees via telehealth peaked in April 2020. . Similarly, the average number of postpartum enrollees served was steady during the study period: OBGYNs served around 70, FPs 20, and both NPs and PAs approximately 10 postpartum enrollees each year.
This unique analysis of data from Medicaid claims showed growth in the CHC perinatal workforce and highlighted the role played by providers from certain specialties and professions in caring for pregnant Medicaid enrollees. Policymakers could leverage these findings to design targeted investments for high-impact provider groups within the CHC perinatal workforce.
社区卫生中心（CHC）为近三分之一的医疗补助孕妇参保者提供护理服务。鉴于医疗补助涵盖了41%的分娩案例，社区卫生中心在确保孕妇参保者获得围产期服务方面发挥着关键作用。尽管其重要性不言而喻，但对于为这些患者提供服务的社区卫生中心工作人员却知之甚少。本研究使用多州医疗补助索赔数据，分析在社区卫生中心为医疗补助孕妇参保者提供护理的医疗服务提供者。
我们的主要数据来源是2016年至2021年的转化医疗补助统计信息系统（T-MSIS）分析文件（TAF）。我们识别出所有在社区卫生中心接受护理的孕妇和产后医疗补助参保者，并研究了来自以下专业领域为该人群提供服务的工作人员：妇产科医生（OBGYN）、执业护士（NP）、家庭医生（FP）和助理医师（PA）。我们总结了每个专业领域每年的医疗服务提供者数量以及每年服务的孕妇和产后参保者总数。由于研究期间与新冠疫情重叠，我们还研究了这些工作人员提供远程医疗服务的情况。
在研究期间，每年在社区卫生中心为医疗补助孕妇参保者提供服务的工作人员数量增长了23%（从22027名医疗服务提供者增至28668名），为产后参保者提供服务的工作人员数量增长了20%（从25655名增至32026名）。在为孕妇（31%对17%）和产后参保者提供护理服务方面，执业护士每年的总数增长速度均快于家庭医生（27%对17%）。在研究期间，妇产科医生和助理医师的数量相对保持稳定。通过远程医疗为孕妇和产后医疗补助参保者提供服务的医疗服务提供者数量在2020年4月达到峰值。同样，在研究期间，每年服务的产后参保者平均数量较为稳定：妇产科医生每年服务约70名，家庭医生服务20名，执业护士和助理医师每年均服务约10名产后参保者。
这项对医疗补助索赔数据的独特分析显示了社区卫生中心围产期工作人员数量的增长，并突出了某些专业领域和职业的医疗服务提供者在照顾医疗补助孕妇参保者方面所发挥的作用。政策制定者可以利用这些研究结果，为社区卫生中心围产期工作人员中具有高影响力的医疗服务提供者群体设计有针对性的投资方案。
