MCC finds barriers to prenatal care in Philadelphia and Norristown

MCC regularly explores the barriers--long waits, less providers, etc-- faced by pregnant women on Medicaid seeking prenatal care at Philadelphia Health Centers and in Norristown. 

MCC expanded these efforts by surveying the entire city of Philadelphia in our Survey of Prenatal Care Availability for Medicaid Managed Care Recipients in Philadelphia. 

There are three managed care organizations' (MCOs) that offer plans to Medicaid recipeints: Keystone Mercy Health Plan, AmeriChoice, and Health Partner's.  MCC checked these three MCOs' provider directories and found that, in the summer 2007:

• The directories were more than 85% inaccurate. 
• Listed providers frequently were no longer available; the phone number was wrong; or the site listed no longer offered prenatal care. 
• Out of 1,500+ listings, only 139 providers at 61 prenatal care sites were available. 
• The waiting time for an initial appointment averaged just above the two-week standard.     

The consequences of inaccurate information were recognized and policy changes have been implemented by some of the MCOs and the Department of Public Welfare to assure consumers have accurate and easily accessible information. 

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Philadelphia Health Care Centers

MCC and Philadelphia Citizens for Children and Youth (PCCY) regularly conduct research solely on the Philadelphia Health Care Centers.  Overall, in the past 2 years, the average wait time has decreased by one week, from 5 to 4 weeks.  However, there is a wide range of availability for a prenatal care appointment, from 3 days to up to 7 weeks. 

*Data collected by PCCY staff

MCC staff annually call each listed provider for all three Medicaid managed care organizations (MCOs) for Norristown to learn how long the wait is for the first available prenatal care appointment.  The charts below summarize what we have learned.  

The first chart shows the averaged results for all three MCOs over the last three years.  The average wait for prenatal care has reduced over time, from 6 weeks in 2005 to 2.9 weeks in 2007.  Over the same period, MCO web sites have listed an average of 89 providers as available to provide prenatal care.  When calling, an average of only 14 providers are actually available (subtracting duplicate listing between the MCOs). 

Prenatal appointments in Norristown (all MCOs)

*These numbers reflect the actual number of providers among the three MCOs, excluding duplicates between their lists. 

The charts below show the individual data collected for each of the three managed care organizations (MCOs). 

Keystone Mercy Health Plan: Prenatal appointments in Norristown

AmeriChoice: Prenatal appointments in Norristown

**These providers were discovered in the process of calling.  None of them were listed on the MCO's web site.  That is, of the 21 listings, 21 were incorrect, and 7 providers were unlisted, but available.

Health Partner's: Prenatal appointments in Norristown

In 2007, we documented the reasons that so many listings were inaccurate.  The pie chart below shows the reasons for inaccuracies and their frequency.