Demographic Variation in Prenatal Care Coordination Receipt and Resulting Birth Outcomes: Evidence From the Wisconsin Medicaid Population

CONTEXT: Medicaid-funded obstetric care coordination services improve birth outcomes. Whether these benefits vary by race/ethnicity or urbanicity is uncertain. OBJECTIVE: We examined whether the associations between Wisconsin Medicaid's Prenatal Care Coordination (PNCC) program and birth outcomes varied by race/ethnicity and urbanicity. DESIGN: Data came from a statewide cohort of birth records and linked Medicaid claims. The treatment was PNCC receipt during pregnancy for the birthing parent (none; assessment/care plan; service receipt). Covariate-adjusted conventional and sibling fixed effects linear probability models computed associations between PNCC treatment and birth outcome risks. We stratified models on birthing parent race/ethnicity (American Indian/Alaska Native non-Hispanic [NH]; Asian/Pacific Islander NH; Black NH; Hispanic; White NH; multiple NH; other NH) or on residence county urbanicity (large central metro; large fringe metro; medium metro; small metro; micropolitan; noncore). SETTING: Wisconsin, US. PARTICIPANTS: A total of 249 502 Medicaid-paid births (2010-2019). MAIN OUTCOME MEASURES: Preterm birth (PTB; gestational age