Pennsylvania Medicaid policy and rural hospital implementation of immediate postpartum contraception

Objectives: This study aimed to assess the importance of Pennsylvania Medicaid immediate postpartum long-acting reversible contraception (IPLARC) reimbursement policy changes for hospital implementation of IPLARC by rurality. Study design: We surveyed clinician leaders at 51 of 82 (62.2%) Pennsylvania hospitals with labor and delivery units in 2022, including 10 of 51 (19.6%) rural and 17 of 51 (33.3%) academic. Results: Six years after Pennsylvania Medicaid began covering IPLARC outside the obstetrical care bundle, only 3 of 10 (30.0%) rural and 18 of 41 (43.9%) nonrural labor and delivery units had implemented IPLARC. Conclusions: Fewer than half of delivering hospitals in Pennsylvania offered access to IPLARC, even after favorable Medicaid reimbursement policy changes. Nonrural hospitals are more likely to offer IPLARC than rural hospitals.