Comparison of Demographic Characteristics and Outcomes Among Medicaid Beneficiaries Using Medicaid Administrative and Birth Certificate Data

State Medicaid programs comprise the largest single payer for obstetric care in the United States, yet little is known about the quality of demographic and outcomes in Medicaid administrative data. We compared demographic characteristics and outcomes in national Medicaid data via the Transformed Medicaid Statistical Information System Analytic Files (TAF) for all persons with a live birth delivery, and National Vital Statistics System (NVSS) birth certificate data for all live births. We calculated percentage-point differences between all measures in the Medicaid and birth certificate data to assess concordance between the data sets. There were higher counts of deliveries in Medicaid relative to birth certificate data, with county and state variation. State-level measures of preterm delivery and Cesarean-section delivery were generally comparable in the two datasets. We observed large differences in the state-level measures of race-ethnicity categories, and substantially lower rates of first-trimester prenatal care initiation in Medicaid compared to birth certificate data.