Medicaid Accountable Care Organization Implementation and Perinatal Claims Documentation of Social Risk Factors.

ABSTRACT:

Importance

Addressing social risk factors (eg, food insecurity) during the perinatal period has the potential to improve pregnancy-related outcomes. While social risk factor diagnosis codes (ie, International Statistical Classification of Diseases, Tenth Revision, Z codes) were introduced in 2016, adoption in claims has been slow. In 2018, Massachusetts' Medicaid program implemented an accountable care organization (ACO) model, including a requirement that all ACOs screen for social risks.

Objective

To assess claims documentation of Z codes in the perinatal period for Medicaid enrollees and evaluate changes in documentation following implementation of Massachusetts' Medicaid ACO program.

Design, setting, and participants

This cross-sectional study used the Massachuset

SUBMITTER: Nguyen KH 

PROVIDER: S-EPMC12013353 | biostudies-literature | 2025 Apr

REPOSITORIES: biostudies-literature