Abstract
Objective
To assess the availability of long acting reversible contraceptive (LARC) methods
in Los Angeles County through providers participating in a California State Medicaid
State Plan Amendment Program called Family Planning, Access, Care and Treatment (Family
PACT).
Study design
This was a cross-sectional telephone survey utilizing “secret shopper” methodology.
From 855 Family PACT providers in Los Angeles County in 2015, a representative sample
of 400 providers was selected for study. Young female researchers posing as potential
patients called each sampled clinic to ask a scripted series of questions about LARC
availability for Family PACT patients in that practice.
Results
All but one eligible practice (99.7%) responded to our questions. Among the 336 responding
practices, 284 said they accepted Family PACT. Of those accepting Family PACT, staff
answering the telephone call at 61% said they did not provide any LARC method onsite,
2% provided all currently available LARC methods, and 6% provided same-day placement
of any LARC.
Conclusion
The majority of Family PACT practices surveyed said that they did not provide any
LARC onsite, and very few provided same-day LARC placement despite easy patient enrollment
procedures, relatively reasonable reimbursement and concerted efforts to increase
LARC use. Substantial barriers to greater uptake may rest at the provider level with
either actual unavailability of LARC or staff perception of unavailability.
Implications
Only a minority of Family PACT practices said that LARC methods were available onsite,
which imposes substantial restriction to access for women who are entitled to have
access without cost. Other states developing programs should be aware of this challenge.
Keywords
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Article info
Publication history
Published online: August 01, 2018
Accepted:
July 25,
2018
Received in revised form:
June 19,
2018
Received:
March 24,
2018
Footnotes
☆Funding Source: None.
☆☆Financial Disclosures: Anita L. Nelson receives Grants/Research support through Agile Pharmaceutical, ContraMed, Estetra SPRL, Evofem Inc, FHI (MonaLisa), Merck; receives Honoraria and serves on Speakers Bureau for Allergan, Bayer, Merck; serves as a Consultant/Advisory Board member for Agile, AMAG Pharma, Bayer, ContraMed, Merck PharmaNest.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
