For the first time in nearly 15 years, a faculty member from Augusta University’s College of Nursing has been awarded a grant from the National Institutes of Health.
Blake McGee, PhD, has secured an R03 award of $176,331 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development to study Medicaid’s expanded role in late postpartum maternal health.
But he hasn’t stopped there as McGee is also part of the fifth cohort of Betty Irene Moore Fellows, a prestigious program for nurse leaders and innovators that has awarded CON half a million dollars to support his research project and leadership development.
McGee, the prelicensure department chair and an associate professor, is collaborating with colleagues from other Georgia universities on both studies, which are occurring simultaneously.
“I began my career as an ER nurse and have always wanted to ask bigger questions about the challenges facing patients and how we might best address them as a society,” said McGee, who was recently selected for publication in Blood Advances, the American Society of Hematology’s journal. “As nursing scientists, we are uniquely poised to ask questions about healthcare policy, specifically from the vantage point of the impact that policy choices have on patients and their health outcomes.”
This century, the United States has seen rising maternal mortality rates with alarming racial disparities. Over half of these deaths occur in the postpartum period, with 23% occurring more than six weeks after delivery. Medicaid expansion covers pregnant women in households below 138% of the Federal poverty level through postpartum day 60, which has been associated with decreased mortality and reduced racial disparity in maternal death.
At the time of grant submission, pregnancy Medicaid eligibility traditionally lapsed 60 days after delivery, leaving postpartum people vulnerable to disruptions in care. McGee’s work aims to identify changes in maternal health care use and health outcomes 60 days to 1 year after delivery that were associated with state Medicaid expansions (2007–19).
The team will examine whether the effects of expansion vary by maternal race or ethnicity and will explore whether patient-reported health care access and quality mediate the relationships between expansion and outcomes.
“My hope is that after the study we’ll have a better understanding of how health and health care use change for women in this crucial late postpartum period and how they may differ for people of different backgrounds,” said McGee. “Due to the sample design, findings will reliably inform optimal policy for postpartum coverage duration.”
He expects this study to provide preliminary data for a future R01-funded study that directly examines the impact of extending the duration of postpartum Medicaid under the American Rescue Plan.
As part of the Betty Irene Moore Fellowship, McGee is one of 15 fellows across the nation in a curriculum co-delivered by the UC Davis School of Nursing and Graduate School of Management. A project coordinator from AU’s School of Public Health will also assist with the fellowship project. McGee hopes to involve graduate research assistants or recent alumni as research associates on the team.
Specifically, McGee will be studying the Georgia Pathways to Coverage Program, making him one of the only academic researchers in the nation funded to do so.
“As a researcher, it is always a privilege to engage in topics that directly impact the current state of health care, and I’m honored to tackle projects that are so relevant to today’s health policy headlines,” he said.
Georgia stands out among other states that are exploring an extension of Medicaid to low-income, working-age adults who demonstrate a monthly commitment of 80 hours to an employment-related activity. By studying the effects of this program, McGee predicts the findings will be highly relevant to anticipating the impact of recent Medicaid changes at the federal level and may indicate differences between Pathways participants and those who might qualify but remain uninsured. This focus could provide data that helps the state target enrollment efforts. The state’s own logic model predicts that the program will reduce hospitalizations, and McGee is eager to determine the program’s success.
“Our findings should be helpful to the state to better understand those enrolling, what their experience with increased access to care has been and how their health has improved after receiving coverage,” McGee said.
