title: The financial effects of expanding postpartum contraception for new immigrants.
abstract: OBJECTIVE
  To estimate the costs of expanding Emergency Medicaid coverage to include postpartum contraception.
  
  
  METHODS
  A decision-analytic model was developed using three perspectives: the hospital, state Medicaid programs, and society. Our primary outcome was future reproductive health care costs due to pregnancy in the next 5 years. A Markov structure was use to analyze the probability of pregnancy over a 5-year time period. Model inputs were retrieved from the existing literature and local hospital and Medicaid data related to reimbursements. One-way and multiway sensitivity analyses were conducted. A Monte Carlo simulation was performed to incorporate uncertainty from all of the model inputs simultaneously.
  
  
  RESULTS
  Over a 5-year period, provision of contraception would save society $17,792 per woman in future pregnancy costs and incur a loss of $367 for hospitals. In states in which 49% of immigrants remain in the area for 5 years, such a program would save state Medicaid $108 per woman.
  
  
  CONCLUSIONS
  Under federal regulations, new immigrants are restricted to acute, hospital-based care only. Failure to provide the option of contraception postpartum results in increased costs for society and states with long-term immigrants.
authors.affiliation: From the Department of Obstetrics, Gynecology, and Reproductive Sciences and the Center for Clinical and Policy Perinatal Research (CPR), University of California, San Francisco, San Francisco, California; the Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon; and the Department of Obstetrics, Gynecology, and Reproductive Sciences, Brigham and Women's Hospital and Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Rodriguez
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Jensen
authors.forename: Philip D
authors.initials: PD
authors.lastname: Darney
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Little
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Caughey
mesh_terms: D000328:Adult; D003267:Contraception / Q000191:economics*; D003362:Cost-Benefit Analysis; D054242:Emigrants and Immigrants; D005193:Family Planning Services / Q000191:economics; D005260:Female; D006801:Humans; D008484:Medicaid / Q000191:economics*; D009010:Monte Carlo Method; D011181:Postnatal Care / Q000191:economics* / Q000379:methods; D014481:United States