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Developmental Biology - Birth Costs
Having a Baby Can Cost $4,500 Out-of-Pocket
The most expensive part of having a baby is birth itself...
One of the most expensive part of having a baby may be birth itself, a new Von Voigtlander Women's Hospital -| Michigan Medicine study suggests. A baby can cost some families $4,500 out-of-pocket.
For some families, average out-of-pocket health care spending for maternity care - including pregnancy, delivery and three months postpartum - jumped from $3,069 in 2008 to $4,569 in 2015, according to findings published in the January issue of Health Affairs.
The Affordable Care Act (ACA), which requires large, employer-based health plans (used by about 50% of U.S. women) to cover maternity care, hasn't protected families from a big brunt of costs.
Why? While the ACA requires full coverage of preventive services, such as pap smears and mammograms, there are few restrictions on how commercial medical plans impose co-pays, deductibles and cost-sharing for maternity care.
"We were surprised to learn that the vast majority of women pay for critical health services tied to having a baby." says lead author Michelle Moniz MD MSc, obstetrician gynecologist at Michigan Medicine's Von Voigtlander Women's Hospital — and researcher at the University of Michigan Institute of Healthcare Policy and Innovation.
"These are not small co-pays - but staggering costs."
Michelle Moniz MD MSc, Obstetrician Gynecologist, Michigan Medicine's Von Voigtlander Women's Hospital; Institute of Healthcare Policy and Innovation.
The study included a national sample of 657,061 women enrolled in 84,178 employer-sponsored plans and hospitalized for childbirth from 2008 to 2015. Researchers analyzed costs for all health care services used before and after delivery that might influence pregnancy outcomes.
Ninety-eight percent of women were found to be paying out-of-pocket costs.
Costs of Childbirth
Childbirth Leading Reason for Hospitalization in Reproductive Age Women
Out-of-pocket C-sections costs increase about 15% a year.
Higher deductible plans, co-pays, and misconceptions about what ACA requires for maternity health care coverage, may be areas advocates and lawmakers target for improvement.
This is especially important as the USA continues to be one of the only developed countries with a rising maternal mortality rate.
According to Moniz, maternity care services are vital to ensuring best possible outcomes for moms and newborns.
"Increasing maternal health costs burdening families over time is concerning. Research tells us out-of-pocket costs for healthcare are often associated with skipped care. Financial burdens put women at risk of delaying or missing maternity care, which we know can lead to poor outcomes for women and babies. Restricting patient spending on maternity care may be an important opportunity to improve maternal and neonatal health for American families."
"There is strong rationale for policymakers to consider policies to protect the average consumer," Moniz adds. "Maternity and childbirth care are essential health services that promote the well-being of families across our country. Reducing patients' costs for these high-value services makes sense."
"We all want babies to have the best possible start in life."
Michelle Moniz MD MSc.
Abstract
The Affordable Care Act (ACA) requires employer-based insurance plans to cover maternity services, but plans are allowed to impose cost sharing such as copayments and deductibles for these services. This study aimed to evaluate trends in cost sharing for maternity care among working women in employer-based plans, before and after the ACA. Our data indicate that between 2008 and 2015, average out-of-pocket spending for maternity care rose among women with employer-based insurance. This increase was largely driven by increased spending among women with deductibles. When we controlled for potential confounders, we found that out-of-pocket spending was higher for lower-income working women in 2008–13, but disparities disappeared in 2014–15 because of a continued rise in spending among higher-income working women. Policies that aim to lower out-of-pocket spending for maternity care could reduce a significant financial burden on families.
Authors
Michelle H. Moniz, A. Mark Fendrick, Giselle E. Kolenic, Anca Tilea, Lindsay K. Admon, and Vanessa K. Dalton.
Acknowledgments
Michelle Moniz receives support from the Agency for Healthcare Research and Quality (AHRQ) (Award No. K08 HS025465). Vanessa Dalton receives support from AHRQ (Award No. R01 HS023784). AHRQ did not play a role in the research design, data collection/analysis, decision to publish, or choice of journals for the manuscript. Vanessa Dalton is a paid expert witness for the Bayer Corporation. The authors thank Sarah Block for assistance with the manuscript preparation..
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Jan 10 2020 Fetal Timeline Maternal Timeline News
 Between 2008 and 2015, average out-of-pocket spending for maternity care rose among women with employer-based insurance. CREDIT Health Affairs.
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