Long-Acting Reversible Contraceptive Methods (All Women)

The All Women LARC Methods is an access measure. Very low measure results, below 1 or 2 percent, might signal barriers to LARC provision which may be explored and addressed through provider training, changes in reimbursement practices, or quality improvement initiatives. The barriers to obtaining LARC are well-documented and include lack of knowledge among eligible people or providers, financial constraints, and logistical issues.

Measure performance rates can also inform quality improvement initiatives by identifying and monitoring gaps in LARC provision. Specifically, they can help health care providers learn about their patient population, identify best practices in care, and track quality improvement progress, acting as a roadmap for enhancing the quality of care and patient satisfaction. The measures were CBE endorsed at the state, health plan, facility, and clinician group level. In addition, many states report this measure to the Centers for Medicare & Medicaid Services (CMS) Child and Adult Core Set program to drive improvement in the quality of contraceptive care provided to Medicaid beneficiaries.

The Contraceptive Care—Access to LARC measure has no specific benchmark and should not be used to encourage high rates of LARC use, as this could lead to coercive practices. This is especially important given the historical use of coercive practices related to contraception, especially among communities of color and people with low income. For the same reason, it is not appropriate to use the All Women Access to LARC measure in a pay-for-performance context.

Starting federal fiscal year (FFY) 2024, reporting of the Child Core Set, which includes OPA’s contraceptive care measures, is mandatory for all states. States should not interpret this mandatory reporting as a desire to reach higher rates of contraceptive provision, but rather as an aim to capture all contraceptive provision rates. Higher rates of contraceptive provision are not associated with higher quality of contraceptive care provided to patients because these rates do not necessarily reflect patient preferences or goals.

Measure performance rates can be used to help identify potential barriers to LARC access.