Medicaid Reimbursement Boosts Postpartum Depression Screening - EMJ

Medicaid Reimbursement Boosts Postpartum Depression Screening

A RECENT cohort study examining over 137,000 births in Colorado has found that Medicaid reimbursement for postpartum depression (PPD) screening during well-child visits is significantly associated with higher rates of billed screenings for maternal depression.

Specifically, the introduction of Medicaid reimbursement in 2014 led to a 9.6–percentage point increase in the likelihood of a billed depression screen being conducted during the first year after childbirth.

The study, which analysed data from the Colorado All Payer Claims Database covering the period from 2013 to 2019, aimed to understand whether financial incentives impacted screening, diagnosis, and treatment for maternal mental health conditions. Researchers compared outcomes for mothers with Medicaid and commercial insurance before and after the policy change. They found that Medicaid-insured mothers not only had a higher probability of being screened but were also more likely to receive a diagnosis for postpartum mood or anxiety disorders. There was also an increase in outpatient mental health treatment, although a small decrease in prescription medication use was observed.

Notably, the policy appeared to drive 18 additional billed depression screens per 100 births, suggesting a meaningful improvement in early detection of PPD, a condition that, if left untreated, can have long-lasting consequences for both mothers and their children. The increase in diagnoses and outpatient treatment highlights the potential for targeted reimbursement policies to improve maternal mental health outcomes.

However, the study also points to persistent challenges. Despite improved screening and treatment rates, barriers to conducting screenings and making referrals in paediatric settings remain. Additionally, accessing appropriate postpartum mental health care continues to be a hurdle for many, particularly those in rural or underserved areas.

Overall, these findings suggest that Medicaid reimbursement for maternal depression screening during routine paediatric care is a promising strategy to boost detection and support for postpartum mental health. Still, the authors emphasise that additional efforts are needed to ensure all mothers can access and benefit from timely and effective mental health care during the critical postpartum period.

Reference

Gordon SH et al. Medicaid reimbursement for maternal depression screening and care for postpartum depression. JAMA Pediatr. 2025;DOI:10.1001/jamapediatrics.2025.1790.

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