An Interrupted Time Series Analysis to Assess the State and Regional Impact of Tennessee Medicaid’s Immediate Postpartum Long-Acting Reversible Contraception Policy Change on Short-interval Births

The primary objective of the proposed research is to determine the impact of a 2017 Tennessee Medicaid (TennCare) policy change on the short interval birth rate. We will investigate the impact the policy that expanded reimbursement for immediate postpartum long-acting reversible contraception (IPP LARC) had on short-interval births at a single institution, regionally and statewide in Tennessee. The secondary objective will aim to look at the impact of this policy change on the rate of short-interval births in these specific populations: adolescents, women with substance use disorder (SUD), and women with high-risk pregnancies (I.e., Diabetes, Hypertension). An additional objective will be to determine the impact of the policy change on uptake of LARC in the immediate postpartum period and to describe the populations utilizing this option at a regional medical center East Tennessee. This objective does not require the long-term follow-up required to compare short interval birth rates and should precede the findings of the primary and secondary objectives by approximately 1 ½ years.

Merck and Company, Inc.