by Brian Eastwood
Across the U.S., about 2 million individuals with private
insurance are admitted to the hospital each year for childbirth. It's the cause
of significant out-of-pocket health care costs, with an average bill of about
$3,000, according to a paper published in June in the Official Journal of the
American Academy of Pediatrics.
What's in the study:
- For one in six childbirths, the out-of-pocket cost
exceeds $5,000, the University of Michigan-based researchers noted in the
paper. The average bill for newborns who are admitted to the neonatal
intensive care unit is also $5,000, with one in 11 bills exceeding $10,000
for NICU care. Only 5% of patients had their hospital stay for childbirth
covered in full by insurance.
- "This is an immense financial burden for families
at a time when they are already paying for future child care," says
the lead author of the study, Michelle Moniz, M.D., an assistant professor
in the Michigan Medicine Department of Obstetrics and Gynecology. For
Moniz and her co-authors, the findings of their research point to a need
for redesigning insurance benefits.
What can payers do:
- Price transparency initiatives among health plans can
address this issue, says Ross Nelson, principal and national health care
strategy leader at KPMG. But plans face two challenges on this front. One
is that patients rarely use price transparency tools — and when they do,
they don't necessarily seek out lower-cost providers.
- The other is that efforts to steer patients to low-cost
providers often backfire, Nelson says. "Giving birth is a bit of a
sacred cow," he adds. "When plans and self-insured employers try
to narrow the network, employees push back. And hospitals are very adept
at letting the benefits managers know that it would not be a good look to
have them out of network."
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