Spillovers From Medicaid Contraceptive Use to Non-Medicaid Patients: Evidence From New York
Date
2025-02-03
Journal Title
Journal ISSN
Volume Title
Publisher
Health Economics
Abstract
This study examines spillovers from a 2014 New York Medicaid policy change that increased reimbursement for immediate postpartum long-acting reversible contraceptive (LARC) insertion. Using administrative data on hospital deliveries from 2011 through 2019, we analyze whether physicians who inserted immediate postpartum LARCs for Medicaid patients following the policy change were more likely to subsequently perform the procedure on non-Medicaid patients. We find significant spillovers, as physicians who first perform an immediate postpartum Medicaid LARC insertion following the 2014 payment reform are 9.3 percentage points more likely to perform immediate postpartum non-Medicaid LARC insertions; an association that increases with the physician's share of Medicaid deliveries. To distinguish between physician-specific and hospital-specific factors driving spillovers, we compare physicians within the same hospital-year. Results indicate approximately half the spillover is due to physician-specific factors and half to hospital-specific factors. Our findings highlight how targeted reimbursement policies can have broader impacts beyond the intended population and demonstrate the influence of both individual physician behavior and institutional factors in shaping clinical practice patterns. Understanding these spillover dynamics is important for policymakers and healthcare providers aiming to promote effective and equitable contraceptive care across patient populations.
Description
This is the peer reviewed version of the following article: Callison, K., Carlos, M. and Willage, B. (2025), Spillovers From Medicaid Contraceptive Use to Non-Medicaid Patients: Evidence From New York. Health Economics, 34: 821-826. https://doi.org/10.1002/hec.4945, which has been published in final form at https://doi.org/10.1002/hec.4945. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
© 2025 John Wiley & Sons Ltd.
This article will be embargoed until 02/03/2026.
Keywords
contraception, Medicaid, reimbursement, spillover
Citation
Callison, K., Carlos, M. and Willage, B. (2025), Spillovers From Medicaid Contraceptive Use to Non-Medicaid Patients: Evidence From New York. Health Economics, 34: 821-826. https://doi.org/10.1002/hec.4945