Using Administrative Claims Data to Address Maternal Health Disparities

Maternal mortality in the United States is more than triple that of other developed countries (Gunja et al., 2022), and it nearly doubled between 2018 and 2021 (Hoyert, 2023). There are also large racial and ethnic disparities in maternal mortality, morbidity, and use of prenatal and postpartum care. In 2021, maternal mortality rates for Black women were more than double those of non-Hispanic white women (Hoyert, 2023). Policies such as postpartum Medicaid expansion (Ranji et al., 2021) and programs such as Healthy Start (Health Resources and Services Administration, 2023) have the potential to improve maternal health outcomes overall and reduce these disparities. However, high-quality, unbiased data are needed to assess whether the benefits of interventions extend to all races and ethnicities. Administrative claims data from health insurers are a secondary data source that can include millions of enrollees. The size and breadth in terms of patient details of the data make it a valuable source for retrospective population health studies. However, because the data are initially collected for billing purposes and only reflect information gathered in a health care setting, researchers must be thoughtful when using claims data for maternal health disparities research. Despite extensive research using claims data, there is little guidance on using such data for health disparity research, much less for studying maternal health disparities.