Baby love and budget relief: some promising practices in prenatal managed care in Medicaid.

The provision of prenatal health care is one of the most important functions of Medicaid, as approximately three-quarters of program enrollees are poor women and children. A rapidly increasing number of states are seeking to address the dual crises of spiralling program costs and inadequate access to services through the use of managed care in Medicaid. Medicaid managed care is growing rapidly and now stands at more than 8 million enrollees, the overwhelming majority of whom are women and children. The focus on accessible preventive and primary care that is, in theory, the hallmark of managed care, should apply well to prenatal health services for Medicaid beneficiaries, though this is not always the case. The more successful managed prenatal care programs thus far have some common characteristics, which are examined here in the hope that they will be replicated by other states.