by: Michel Boudreaux
I was thrilled to be accepted into AcademyHealth’s New Investigator Small Grant Program (NISGP). I am now more than half-way through my grant year. AcademyHealth’s NISGP in partnership with the Association for Community Affiliated Plans (ACA) and the March of Dimes (MOD) has provided an excellent opportunity to network with established experts while receiving financial support (from MOD) and building a track record of externally funded research.
My research focuses on the impact of Massachusetts’ landmark health reform initiative on infant and maternal health, two bell weathers of population health that the U.S. has historically lagged on. The many parallels between the Affordable Care Act (ACA) and the Massachusetts reform make Massachusetts an informative case study for what is currently unfolding under the ACA.
For the past several decades many have hypothesized that high levels of uninsurance contribute to poor infant and maternal health outcomes. Expansion of Medicaid in the 1980’s and 1990’s was largely predicated on the notion that if we expanded Medicaid to low-income pregnant women they would be more likely to access prenatal care and their infants would be born healthier as a result. However, a handful of important studies found that the Medicaid expansions had only moderate impacts on measures such as low birthweight. A possible explanation for that result is that many women delayed getting care until late in pregnancy because they were not eligible for coverage until after they were pregnant. Not only did eligibility rules make early prenatal care initiation difficult, but pregnancy-related eligibility did not promote pre-conception health and it did little to protect household finances from long-term medical risks.
The Massachusetts reform was fundamentally different from the Medicaid expansions of the 1980’s and 1990’s. Health insurance was expanded to all adults regardless of pregnancy status. The reform mandated that everyone obtain coverage and health insurance reached near universal levels. Health care access and use increased, adult health improved, and medical debt declined. My study is the first to examine if the Massachusetts reform had an effect on infant and maternal health.
The NISGP has been a great resource. The program has provided key financial support that lets me focus on the study. I was paired with a mentor that is a national leader in neonatology. He has been extremely generous with his time, proving guidance on research design and data issues and offering a clinical perspective that complements my health services research training. Finally, the NISGP has been a great way to get exposure and build a track record of externally funded research. That track record was essential in helping me write a successful grant application to the Health Resources and Services Administration which is supporting the purchase of additional data and the inclusion of more personnel on the study.
With the resources provided by the NISGP, I have made excellent progress at the half-way point (July 2015) of my grant year. The data are nearly finalized, and I am on track to be done with analysis by late October. The NISGP has been a great partner in my research and professional development, and I am grateful I have had the opportunity to participate.