STREAMR Study

STudy of Racial Equity Among Medicaid Recipients

The STREAMR Study is designed to understand if and how Medicaid policies in Pennsylvania promote and improve maternal and infant health and well-being, particularly for Black populations. State Medicaid programs are the largest single payer for pregnancy and birth in the United States, covering 65% of births to Black people. Pennsylvania Medicaid is currently implementing several policies with the goal to advance racial equity in pregnancy and child health. STREAMR will investigate the effects of the following Medicaid healthcare quality policies:

1. The equity incentive payment program makes available $26 million in Medicaid managed care organization (MCO) payments and are available to plans that improve access to timely prenatal care and well-child visits among Black beneficiaries
2. The equity-focused maternity care bundled payment model provides incentives to obstetric providers across a wide range of pregnancy health outcomes and specifically incentivizes improvements among Black beneficiaries
3. The Regional Accountable Health Councils are groups tasked with identifying geographic areas with profound health inequities and designing equity-focused community interventions

4. Medicaid is developing processes for reimbursement for doula care for pregnant and birthing people across the state of Pennsylvania

STREAMR addresses a critical need for high-quality evidence about how policy interventions address racial equity in maternal and infant health, including severe maternal morbidity. Our findings will provide qualitative and quantitative data about how Medicaid policy interventions can be used to advance racial health equity in maternal and infant health. Our study design includes:

1. Qualitative data with diverse stakeholders including Medicaid beneficiaries, Managed Care Organization (MCO) plan representatives, obstetric and pediatric care clinicians, and doulas across Pennsylvania
2. A community-partnered approach to develop a quantitative analysis plan of Medicaid administrative data for Pennsylvania and across the United States

Meet the Team

• Dara D. Méndez, Co-Principal Investigator
• Marian Jarlenski, Co-Principal Investigator
• Cynthia L. Salter (Co-Investigator)
• Christine L. McClure (Co-Investigator)
• Evan S. Cole (Co-Investigator)
• Marquita N. Smalls (Project Manager)
• Andrea D. Casas (Research Scientist)
• Sarah A. Sanders (Postdoctoral Associate)
• Noelle Spencer (Postdoctoral Associate)
• Iris Olson (Center Manager, CONVERGE)
• Jeremy Bilfield (Senior Data Analyst)
• Sabin Gaire (Senior Data Analyst)
• Linda Adodoadji (Data Scientist)
• Elizabeth Lusardi (Clinical Research Coordinator)
• Claire Lama (Graduate Research Assistant)
• Sydney Sharp (Medical Student)

Community Partners

• Joanne Craig, Chief Impact Officer, The Foundation for Delaware County 
• Nichole Lehr, Senior Director of Maternal and Child Health, Hamilton Health Center
• Sarah Jann Heinze, Senior Director of Policy and Advocacy, Maternity Care Coalition
• The Midwife Center, Christine Haas, Executive Director
• Healthy Start, Inc.

     Jada Shirriel, CEO
     Demia Tyler, Director of Strategic Initiatives
     Adena Bowden, Research Manager
     Brynnaiza Young, Policy & Advocacy Project Manager

• Pennsylvania Doula Commission

     Gerria Coffee, President
     Aleta Heard, Vice President
     Lauren Pietrowski, Secretary

How to Get Involved

We are actively recruiting Medicaid recipients for focus groups as well as doulas and clinicians for interviews. If you would like more information or are interested in participating, email streamr@pitt.edu or call 412-624-3029. 

Medicaid Recipient Focus Groups

We are looking for people who are currently pregnant of have recently been pregnant (within the last 3 years) that are current or past Medicaid participants to join our research study on medical insurance and racial health equity by participating in a 90-minute focus group. Receive $40 compensation. 

Share your experiences

Doula Interviews

We are looking for doulas across PA who have provided care to pregnant and postpartum people in PA during the last year to join our research study on medical insurance and racial health equity by participating in a 40-60 minute interview. Receive $50 compensation. 

Share your experiences

Clinician Interviews

We are looking for physicians, midwives, nurses, NPs, PAs and other clinicians who provide care for pregnant and postpartum populations, infants and children, serve black families and serve Medicaid beneficiaries. Join our research study on medical insurance and racial health equity by participating in one, 40-60 minute interview. 

Share your experiences