Trends and regional variations in provision of contraception methods in a commercially insured population in the United States based on nationally proposed measures

Abstract

ObjectivesThree measures to assess the provision of effective contraception methods among reproductive-aged women have recently been endorsed for national public reporting. Based on these measures, this study examined real-world trends and regional variations of contraceptive provision in a commercially insured population in the United States. Study designWomen 15–44years old with continuous enrollment in each year from 2005 to 2014 were identified from a commercial claims database. In accordance with the proposed measures, percentages of women (a) provided most effective or moderately effective (MEME) methods of contraception and (b) provided a long-acting reversible contraceptive (LARC) method were calculated in two populations: women at risk for unintended pregnancy and women who had a live birth within 3 and 60days of delivery. ResultsDuring the 10-year period, the percentages of women at risk for unintended pregnancy provided MEME contraceptive methods increased among 15–20-year-olds (24.5%–35.9%) and 21–44-year-olds (26.2%–31.5%), and those provided a LARC method also increased among 15–20-year-olds (0.1%–2.4%) and 21–44-year-olds (0.8%–3.9%). Provision of LARC methods increased most in the North Central and West among both age groups of women. Provision of MEME contraceptives and LARC methods to women who had a live birth within 60days postpartum also increased across age groups and regions. ConclusionsThis assessment indicates an overall trend of increasing provision of MEME contraceptive methods in the commercial sector, albeit with age group and regional variations. If implemented, these proposed measures may have impacts on health plan contraceptive access policy.