Beyond Policy Innovation: Analyzing Access to Long-Acting Reversible Contraception




Bermea, Megan M.

Journal Title

Journal ISSN

Volume Title



Purpose: Access to highly-effective birth control methods, including long-acting reversible contraception (LARC), is essential to advance the health and well-being of women and their families, and is a critical key to address persistent rates of unintended pregnancy in the U.S. However, considerable barriers to LARC access exist and policy innovation is necessary to drive progress and improve maternal health outcomes. The purpose of this applied research project is to categorize and describe the innovative policies and practices states have implemented to improve access to LARC and the outcomes of this innovation. Methods: This research involves content analysis of a standardized selection of Medicaid State Plans, family planning policy manuals, LARC toolkits and guidelines, and other applicable state documents that provide information on access to LARC and contraception. The research sample was chosen using stratified random sampling of 25 states (n=25) based on their expansion of Medicaid. This study analyzed state LARC policies in the categories of LARC billing and payment, operations, training, and outreach. Findings: This study found that within the research sample, complete evidence of LARC training policy innovation was represented by 24% of states, complete evidence of billing and payment innovation was found in 16% of states, complete evidence of outreach innovation was found in 12% of states, and none of the states in the research sample showed complete evidence of LARC operational innovation. States must fully operationalize their innovative LARC policies to yield measurable results and moreover, LARC funding innovation and Medicaid expansion are other key factors that have tremendous potential to increase access to LARC and improve maternal health outcomes.


An Applied Research Project Submitted to the Department of Political Science, Texas State University, in Partial Fulfillment for the Requirements for the Degree of Masters of Public Administration, Summer 2020.


health policy, policy innovation, women's health, contraception, long-acting reversible contraception, birth control, maternal health outcomes, unintended pregnancy, health equity, Public Administration


Bermea, M. M. (2020). Beyond policy innovation: Analyzing access to long-acting reversible contraception. Masters of Public Administration, Texas State University, San Marcos, Texas.


Rights Holder

Rights License

Rights URI