Knowledge and Understanding of P4HB ® Findings .1 Overall Lack of Program Information

Overall, P4HB^® enrollees and eligible women who participated in the focus group had limited knowledge of P4HB^® and its covered services. Women seemed confused by the nature of the program as well as the types of services that were available to them. In some instances, women did not know they were in the program until they went to their health care provider for birth control. One woman, “Maureen,” 19, Atlanta was surprised to learn she was in a family planning program, when she went to her local health clinic.

“I never knew what it was until when I went to get some birth control and they were like OK well you have Planning for Healthy Babies Program^® and I’m like OK what does that mean?”

Several women in the focus groups, such as “Maureen”, were unaware they were enrolled in P4HB^®, likely because they were auto enrolled after their eligibility for Peach Care or RSM Medicaid ended. Yet a few participants were told they were enrolled in P4HB^® and still seemed confused. “Heather”, 20, from Northwest Georgia, received a call about P4HB^® after the delivery of her baby and was still unsure about the program.

“I was, been kind of confused on the whole, the Planning for Healthy Babies Program^® thing. I haven’t known much about it and how it works or anything.” Another woman,

“Felicity”, 19, Northwest Georgia, was also confused even though she’d received materials in the mail, “Well, I’ve been getting stuff for Planning for Healthy Babies Program^® and stuff. But I just didn’t even know that I was like am I even in this?

Because she’s (her mother) like yes, you got a card.”

154 5.6.2 Benefits Beyond Birth Control

Among the women who were aware they were enrolled in P4HB^®, a majority understood that the program covered birth control and their annual exams. However, there was a clear lack of understanding about the scope of benefits among this group.

Women asked a range of questions, such as whether the program covered ultrasounds, tubal ligation, HIV screening, fibroid removal surgery (myomectomy), infertility testing, and abortion. Women also wanted to know the various kinds of birth control that were covered. “Violet”, 32, Atlanta, who does not want any more children, asked if Essure, the permanent birth control implant, was covered. Another woman, “Rebecca”, 26, Atlanta, wanted to know if P4HB^® covered the IUD even for childless women. “Going back to the birth control methods, I know that here they offering IUDs but they have a waiting list, and they want you to have a child already. Well I would like the IUD, and I don’t have kids…being in Planning for Healthy Babies Program^® ..would it be covered?” Another woman, “Candice,” 19, Atlanta, asked if calcium supplements were covered, because her doctor told her to take them since she was on Depo.

Some of the confusion about P4HB^® stems from the materials women received about the program. These materials included CMO materials and DCH-issued P4HB^® postcards and flyers. Several women read the materials and thought they would receive primary care and dental services. One woman, “Teresa,” 39, Atlanta, said “I didn’t realize I wasn’t getting everything that was on that list on the flyer.” Another woman, “Usha,”

23, Atlanta, read a P4HB^® flyer she received from Amerigroup:

As a matter of fact I have a little flyer, oh no I think I left it in my car, but I have a flyer in my car and I was under the impression that I would get dental as well…it

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said, you know, if you’re in Planning for Healthy Babies Program® , blah, blah, blah, blah, inter-pregnancy care is this, and family planning is this, and then it says you may get dental, primary. But it doesn’t explain that only the IPC women get it.

Another woman, “Jaden”, 23, Atlanta, thought dental care was covered and called her CMO, Well Care, to clarify her coverage. “When I called, like and I was looking in a book and I didn’t see nothing about no dentist, so I just called and they was like no, you have to have low weight baby, I’m like why I have to have a low weight baby to get dental?” In these instances, women were reading benefit information about the IPC component and did not understand the differences between the two eligibility groups.

There appeared also a lack of awareness about IPC among the two participants who were enrolled in this component of P4HB^®. For “Yvette,” who lost her infant after 5 months, the lack of information about P4HB^® was frustrating:

..they didn’t explain nothing to me, only that you are eligible and then you just lost the baby so go fill out for Planning for Healthy Babies Program® and that was it. Now I appreciate it, don’t get me wrong, but I’m just saying like you put somebody on something, you don’t even get it explained on the phone what it covers, and it don’t cover, they didn’t send no booklet or nothing.

And for “Quintessa,” she thought she was in a “family planning insurance program” that only covered birth control. After discussing her experience, however, she mentioned receiving calls every three months from a Resource Mother who asks her about her baby.

So like “Yvette,” “Quintessa” does not have a complete understanding of the scope and benefits of the IPC component of P4HB^®.

5.6.3 P4HB^® name

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Another source of confusion among current as well as prospective P4HB^® enrollees was the name of the program. Several women initially thought “Planning for Healthy Babies Program^® ” implied a program aimed at mothers or women who wanted to get pregnant. When asked about her current P4HB® experience, one participant said

“I’m using Medicaid. I really don’t know much about this. I don’t have a baby.” Another woman, “Ilena,” 19, Northwest Georgia, explains her view on the name of the program,

Ilena: I thought, you know, that it was only for women who had kids and babies because I never got offered it before, you know.

Facilitator. What made you think that?

Ilena. Planning for Healthy Babies Program® , the name of it.

One participant, “Felicity,” has been enrolled in P4HB^® for eight months and has not sought family planning services because she was confused about the program. “I’m confused like because I didn’t think, like Planning for Healthy Babies Program^® don’t sound like, you know, you’ll be able to get birth control, you know. It sounds like, kind of like the opposite”. These comments provide possible explanation for how, as reported previously, some of the participants (14.3%) may have heard about P4HB^® but decided not to enroll. Indeed, they may have heard the name Planning for Healthy Babies Program^® and if after misreading the program materials, as other participants reported doing, the participants declined participation in the program.