Palm HC, et al. - Researchers identified encountering complexity in implementing immediate postpartum long-acting reversible contraception implementation and the necessity for a committed multidisciplinary team. Following approval of reimbursement for this service by New Mexico Medicaid, an evidence-based implementation program containing several components was developed and initiated by the New Mexico Perinatal Collaborative. In this study, they examined several New Mexico rural hospitals for appraising the timing of the implementation process and facilitators and barriers to immediate postpartum long-acting reversible contraception. They conducted this mixed-methods study from April 2017 to May 2018. In this study, they administered semistructured questionnaires and conducted interviews with 20 key personnel from 7 New Mexico hospitals that planned to implement immediate postpartum long-acting reversible contraception. Forty-three interviews were conducted during the 14-month study period. Completion of steps toward implementation—patient education, clinician training, nursing education, charge capture, available supplies, and protocols or guidelines—was achieved in the median period ranging from 7 days for clinician training to 357 days to develop patient education materials. Local hospital clinical champions and institutional administrative and financial stability were the facilitators of immediate postpartum contraception readiness. Observations suggest that most hospitals did not provide immediate postpartum long-acting reversible contraception over the study period despite the robust implementation process and hospital engagement in New Mexico Perinatal Collaborative. Full-service implementation was prevented because of reimbursement obstacles. Implementation of seamless billing and reimbursement mechanisms to ensure adequate hospital payments are prerequisites for improving the implementation of interventions to improve immediate postpartum long-acting reversible contraception access.