From Childbirth Connection

The Cost of Having a Baby in the United States

Maureen P. Corry, MPH

Disclosures

May 09, 2013

In This Article

Total Maternity Care Cost Analyses

Total Average Maternal-Newborn Costs

The average total maternal and newborn charges and costs were summed to create estimates of the total maternity care charges and costs inclusive of maternal and newborn care. Table 1 shows average total maternity charges and costs estimates for Commercial and Medicaid beneficiaries overall and by childbirth method. Average total maternity charges were approximately 40% lower for vaginal childbirths when compared to cesarean childbirths for both Commercial and Medicaid beneficiaries. Among Commercial beneficiaries, average total maternity care charges were $32,093 for vaginal births and $51,125 for cesarean births. Average total maternity care Commercial payments for vaginal and cesarean childbirths were $18,329 and $27,866, respectively. Average charges to Medicaid were $29,800 for vaginal births and $50,373 for cesarean births. Average total Medicaid maternity payments for vaginal and cesarean childbirths were $ 9,131 and $13,590, respectively. Both Commercial and Medicaid payers paid approximately 100% more for cesarean than vaginal births. For both types of birth, Commercial payers paid approximately 100% more than Medicaid.

Table 1. Average Total Maternal-Newborn Health Care Charges and Payments for Vaginal or Cesarean Births Among Commercial and Medicaid Beneficiaries, 2010

  Total Vaginal Childbirth Cesarean Childbirth
Commercial
Provider Charges $37,340 $32,093 $51,125
Allowed Paid Amount $21,001 $18,329 $27,866
Medicaid
Provider Charges $35,481 $29,800 $50,373
Allowed Paid Amount $10,350 $9,131 $13,590

Note: Commercial results are weighted to reflect the national employer-sponsored insurance population. Costs include the prenatal, childbirth, and 3-month postpartum period and newborn care from birth through the first three months of life.

Source of Payment Analyses

The study examined the source of payments, which were the primary payer (employer-provided Commercial insurance or Medicaid), a secondary insurer such as a union, and out-of-pocket costs (Figures 1 and 2). Among total maternal-newborn payments for beneficiaries with Commercial insurance and vaginal births, on average the primary insurer paid the largest proportion of costs ($15,931 or 87%), out-of-pocket costs averaged $2,244 (12%), and secondary insurers covered a small portion ($153 or 1%). Among total maternal-newborn payments for beneficiaries with Commercial insurance and cesarean births, on average the primary insurer paid $24,949 (90%), out-of-pocket costs were $2,669 (10%), and secondary insurers paid $267 (1%) (numbers exceed 100% due to rounding).

For both vaginal and cesarean births covered by Medicaid (Figure 2), Medicaid paid nearly all costs for vaginal ($9,002 or 99%) and cesarean ($13,327 or 98%) births.

Figure 1.

Average total maternal-newborn health care payments by payment source among commercial beneficiaries with vaginal and cesarean births, 2010.
Note: Commercial results are weighted to reflect the national employer-sponsored insurance population. Costs include the prenatal, childbirth, and 3-month postpartum period and newborn care from birth through the first three months of life.

Figure 2.

Average total maternal-newborn health care payments by payment source among Medicaid beneficiaries with vaginal and cesarean births, 2010.
Note: Because the Medicaid database is comprised of a small convenience sample of 7 states and 5 Medicaid managed care plans, the results are not weighted to the national Medicaid population. Costs include the prenatal, childbirth, and 3-month postpartum period and newborn care from birth through the first three months of life.

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