LAUSR

Women are often highly motivated to obtain contraception during the immediate postpartum period. However not all women receive contraception, particularly LARC methods, during this time. One barrier to immediate postpartum contraception is the cost of placing LARCs, as such devices have a large upfront cost, and historically could not be charged separately from the global delivery fee. In 2017, Florida Medicaid unbundled the fee for the LARC device and insertion from the Diagnosis Related Group and encouraged Medicaid Managed Care plans to do the same. The Florida Perinatal Quality Collaborative, in recognition of guidance put forth by other states, designed the Access LARC initiative to have two phases - the Pre-Implementation Phase and the Implementation Phase. After completing all steps in the Pre-Implementation phase, one pilot hospital placed 195 LARCs during the first five months of the initiative. During this trial period, setbacks in the reimbursement process occurred for both the hospital and payer groups. The Agency for Health Care Administration was instrumental in providing assistance to overcome these setbacks. While there were obstacles and setbacks along the way, this initiative was finally a success for our providers and patients. We encourage other hospitals and states to implement their own postpartum LARC initiative utilizing the guidelines set forth by Florida's Access LARC initiative.