Family Planning Needs and Services in the United States Family Planning Research Cooperative Agreement FPRPA006017 Sup

1. Family Planning Needs and Services in the United StatesFamily Planning Research Cooperative Agreement #FPRPA006017Supported by:The Office of Population Affairs, DHHS Grant recipient: Guttmacher Institute Grant Period 9/30/04 � 9/29/09

2. Family Planning Needs and Services in the United States Background Goals and Objectives Key Project Components Project activities Results so far Importance of these data to policy and program efforts

3. Project Goal:�To provide core information and analyses that program planners and providers can use to improve the delivery of quality family planning services, and through this, to increase the success with which U.S. women and their partners prevent unplanned pregnancies.�

4. Project Objectives To provide accurate up-to-date information on major aspects of U.S. family planning service provision critical to program planners: How many women continue to need publicly funded care and what are their characteristics? How well is this need being met? What is the impact of providing publicly funded contraceptive care? How are clinics adapting to the rising costs of contraceptive service provision? How is financing for family planning service provision changing? What challenges are created by an increasingly diverse population base?

5. Family Planning Needs and Services in the United StatesCooperative Agreement between the Guttmacher Instituteand the Office of Population Affairs, DHHS (2004-2009)

6. Women in NeedProject Activities Number of Women in Need (WIN) of Publicly Funded Contraceptive Services and Supplies: 2004 (National and state level) 2006 (National, state and county level) 2008 (National and state level)

7. Women in Need Change 2000-2004

8. Clients ServedProject Activities Annual updates of the Family Planning Clinic Database Confidential provision of clinic list to NSFG interviewers Number of women served at clinics in 2006 National, state and county level data Fielding to begin early in 2007

9. Unmet Need AnalysisProject Activities Background Prior work has calculated the % of WIN of publicly funded services who are served by clinics (about 40%) Unknown is how many women receive publicly funded care from private doctors This project will estimate the number of women who are served by private MDs using public funds (eg Medicaid) Comparing this to our prior work, we can finally say how much of total need is met by clinics or by private providers And, how much is still �unmet�

10. Impact of Publicly Funded Family Planning ServicesProject Activities Unintended pregnancies averted by publicly funded family planning care Cost savings that result from preventing unintended pregnancies Two rounds of analysis during project: 2004 analysis nearly complete 2006 analysis based on new data and will Explore how to measure other types of benefits

11. Calculating Unintended Pregnancies Averted

12. Unintended Pregnancies AvertedPreliminary Results In 2004, an estimated 1.4 million unintended pregnancies were averted among women served at all publicly funded clinics Nearly 1 million of these unintended pregnancies were averted among women served at Title X clinics Cost savings for 2004 are being calculated using FPAR revenue data; next cost-benefit round will use our Public Funding Survey

13. Public Expenditures for Family PlanningProject Activities Updated data to be collected for FY 2006 Surveys will be mailed in early 2007 to: All Title X grantees and Health, Social Service and Medicaid Agencies in all 50 states and DC

14. Rising Costs of Family Planning CareProject Activities 2005 Survey of Title X Grantees Collected data on: The amount spent per contraceptive client for selected services Per client costs compared to Medicaid reimbursement rates

15. Total Cost for Initial Visit and Amount Reimbursed by Medicaid (n=19 for all) Although it varied widely, Medicaid reimbursed, on average, for 54% of the cost of an initial visit in FY 2004. The cost of an initial visit has grown by an average of 24% over three years. Reimbursement grew more slowly on average (15%), and was stable in 9 of the 19 respondents. The proportion of cost reimbursed by Medicaid has dropped by an average of 4% over three years for an initial visit. (We had similar findings for annual visits.)(n=19 for all) Although it varied widely, Medicaid reimbursed, on average, for 54% of the cost of an initial visit in FY 2004. The cost of an initial visit has grown by an average of 24% over three years. Reimbursement grew more slowly on average (15%), and was stable in 9 of the 19 respondents. The proportion of cost reimbursed by Medicaid has dropped by an average of 4% over three years for an initial visit. (We had similar findings for annual visits.)

16. Contraceptive Supplies and Lab Tests Expenditures on contraceptive supplies increased faster than Title X grants over three years, 26% vs. 11% (n=14). Contraceptive supplies averaged 14% in 2004 as a proportion of respondents� total grant; that proportion had increased by an average of 12%. The increase in expenditures on lab tests was even faster: 109%, vs. 10% for Title X grants (n=11).As a proportion of their total grant amount, spending on lab tests averaged 8% in 2004 and had increased by an average of 98%. Expenditures on contraceptive supplies increased faster than Title X grants over three years, 26% vs. 11% (n=14). Contraceptive supplies averaged 14% in 2004 as a proportion of respondents� total grant; that proportion had increased by an average of 12%.

17. Ways these data help to inform policy and program efforts

18. To sign up for �News Providers Can Use� visit www.guttmacher.org