Abstract
Introduction
High-quality family planning services help women to achieve their preferred family
size and birth spacing, which in turn leads to improved health outcomes and better
quality of life. This study investigates whether women have access to a 1-year supply
of oral contraceptives (OCs) on site when they receive care at community health centers
and whether states require coverage for a 1-year supply.
Methods
This study used a concurrent, mixed-methods approach, with a single phase of quantitative
research (survey of health centers) and two phases of qualitative research (50-state
policy environment scan and in-depth interviews).
Results
Only three states require coverage for a 1-year supply of OCs under all Medicaid and
private insurance coverage mechanisms; the majority of states limit it through at
least one mechanism. The survey found that 50.9% of health centers provided OCs on
site, and of these, only 29.9% offered up to a 1-year supply at a time. An analysis
of interviews revealed that clinician and pharmacist preferences and the organization's
overall approach to family planning played a role in these practices.
Conclusion
This study finds that that only a minority of health centers provide a 1-year supply
on site and that a minority of states have rules requiring coverage for a 1-year supply
of OCs. To remedy these gaps, change is needed at multiple levels, including health
center practices, clinician knowledge and beliefs, federal agency guidance, and state-level
insurance policy.
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Biography
Julia Strasser, DrPH, MPH, is a Senior Research Scientist in the Department of Health Policy and Management and the Fitzhugh Mullan Institute for Health Workforce Equity at the George Washington University Milken Institute School of Public Health. Her research interests include reproductive health, Medicaid, and community health centers.
Biography
Anne Rossier Markus, PhD, MHS, JD, is Professor and Chair, Department of Health Policy and Management, The George Washington University Milken Institute School of Public Health. Her research focuses on the financing and organization of health care and access to quality care.
Biography
Susan F. Wood, PhD, is Research Professor of Health Policy and Management and Director, Jacobs Institute of Women's Health, The George Washington University Milken Institute School of Public Health. Her research focuses on women's health and the use of science in health policy making.
Article info
Publication history
Published online: May 17, 2021
Accepted:
April 12,
2021
Received in revised form:
April 8,
2021
Received:
October 8,
2020
Footnotes
Funding Statement: This article was developed from a doctoral dissertation (Strasser). The Clara Schiffer Fellowship on Women's Health provided financial support for the dissertation research.
Identification
Copyright
© 2021 Jacobs Institute of Women's Health. Published by Elsevier Inc.
