Public Health Insurance Expansions and the Use of Non-Physician Providers: Evidence from Certified Nurse Midwives

57 Pages Posted: 3 Jun 2024

See all articles by Sukriti Beniwal

Sukriti Beniwal

Georgia State University

Lauren Hoehn-Velasco

Georgia State University - Andrew Young School of Policy Studies

Diana Jolles

Frontier Nursing University

Date Written: June 01, 2024

Abstract

This study considers whether the Affordable Care Act (ACA) Medicaid Expansions resulted in changes in the use of non-physician providers. Medicaid Expansions may have impacted both payments to providers as well as insurance availability for patients. Using U.S. birth certificate records, we analyze whether the ACA Medicaid expansions influenced the trade-off between physicians and certified nurse-midwives (CNMs/CMs) for obstetric care. Our findings indicate that the ACA Medicaid expansions led to an increase in the utilization of CNMs/CMs and a decrease in physician-reported deliveries. This shift from physicians to CNMs/CMs is particularly noticeable in states with Medicaid reimbursement parity for CNMs/CMs. These results suggest that health insurance expansions may increase the use of non-physician providers, but only in cases where non-physician providers are reimbursed similarly to physicians.

Keywords: maternal health, Affordable Care Act, non-physician provider, Medicaid reimbursements, ACA Medicaid Expansions, certified nurse midwife

JEL Classification: I18, I11, I13, H51

Suggested Citation

Beniwal, Sukriti and Hoehn-Velasco, Lauren and Jolles, Diana, Public Health Insurance Expansions and the Use of Non-Physician Providers: Evidence from Certified Nurse Midwives (June 01, 2024). Available at SSRN: https://ssrn.com/abstract=4851919 or http://dx.doi.org/10.2139/ssrn.4851919

Sukriti Beniwal

Georgia State University ( email )

35 Broad Street
Atlanta, GA 30303-3083
United States

Lauren Hoehn-Velasco (Contact Author)

Georgia State University - Andrew Young School of Policy Studies ( email )

Department of Economics
35 Broad Street, 6th Floor
Atlanta, GA 30303-3083
United States

Diana Jolles

Frontier Nursing University ( email )

United States

Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Downloads
9
Abstract Views
54
PlumX Metrics