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Mean Out-of-Pocket Spending >$3,000 for Childbirth Episodes

Last Updated: June 17, 2021.

THURSDAY, June 17, 2021 (HealthDay News) -- During 2016 to 2019, privately insured families had mean total out-of-pocket spending of $3,068 for the childbirth episode, including delivery and newborn hospitalization, according to a study published online June 17 in Pediatrics.

Kao-Ping Chua, M.D., Ph.D., from the University of Michigan in Ann Arbor, and colleagues estimated out-of-pocket spending across the childbirth episode, including deliveries and newborn hospitalizations, using 2016 to 2019 data from Optum's deidentified Clinformatics Data Mart, which includes 12 million annual privately insured enrollees.

Data were included for 398,410 episodes; deliveries in these episodes were linked to 404,449 newborn hospitalizations. Overall, 29.4 percent of these episodes were covered by high-deductible health plans. The researchers found that the mean out-of-pocket spending was $2,281 and $788 for the delivery and newborn hospitalization, respectively. The mean total out-of-pocket spending was $3,068, which included deductibles, coinsurance, and copayments (42.1, 55.8, and 2.2 percent, respectively). For 95.0 percent of the episodes, spending exceeded $0, and exceeded $5,000 and $10,000 for 17.1 and 1.0 percent of episodes, respectively.

"Before delivery, clinicians should counsel privately insured families to understand their childbirth benefits and to save money when possible if large bills are expected," the authors write. "After delivery, clinicians should screen families for financial hardship, particularly families experiencing resource-intensive hospitalizations, such as those involving neonatal intensive care."

One author disclosed financial ties to the pharmaceutical, medical care, and health insurance industries.

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