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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
Abstract Award
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Foundation Awardee

Oral Concurrent Session 9 - Quality

Oral Concurrent Sessions

Oral Concurrent Session 9 - Quality

(95) Virtual Maternity Program Engagement and Neonatal Outcomes: A Medicaid Dose-Response Analysis

Friday, February 13, 2026
9:15 AM - 9:30 AM  
Location: Summit 218 - 221
Objective:
To evaluate the association between duration of prenatal engagement with a virtual maternity program and Neonatal Intensive Care Unit (NICU) and preterm birth outcomes in a six-state Medicaid population.

Study Design:
This retrospective claims analysis (1/1/2024-3/31/2025) assessed NICU average length of stay (ALOS), NICU admission rates, NICU costs, and preterm birth as primary outcomes. Engagement duration (1+, 2+, or 3+ months) with the virtual maternity program was the primary exposure. Inverse probability weighting and double-robust regressions adjusted for demographics, prior healthcare use and outcomes, and medical conditions.

Results:
Among 6,630 patients engaged for 1+ months, NICU ALOS decreased by 11.48% (p < 0.05), NICU admissions by 4.08% (p >0.1), NICU cost by 7.36% (p >0.1), and preterm birth increased by 2.67% (p >0.1) (Table 1). For 4,550 patients engaged for 2+ months, NICU ALOS decreased by 15.56% (p < 0.05), NICU admissions by 6.40% (p >0.1), NICU cost by 9.92% (p < 0.1), and preterm birth decreased by 9.59% (p < 0.1). For 3,008 patients engaged for 3+ months, NICU ALOS decreased by 26.80% (p < 0.001), NICU admissions by 12.56% (p < 0.05), NICU cost by 17.40% (p < 0.01), and preterm birth decreased by 18.84% (p < 0.01). These reductions can be attributed to the program's direct medical care, including 24/7 remote management of conditions, mental health support, social needs support, and continuous care coordination.

Conclusion:
Lengthy NICU stays create significant financial and emotional burdens, especially for underserved populations. This study demonstrates a significant inverse dose-response relationship between virtual maternity program engagement duration and NICU ALOS, admissions, costs, and preterm birth rates in a multi-state Medicaid cohort. Longer engagement is associated with greater reductions and statistical significance, suggesting these programs can improve neonatal outcomes and mitigate prolonged NICU admissions and associated costs.