From Childbirth Connection

The Cost of Having a Baby in the United States

Maureen P. Corry, MPH

Disclosures

May 09, 2013

In This Article

Type of Service Analyses

Figures 3 and 4 present total maternal and newborn costs by type of service and mode of birth for Commercial and Medicaid populations, respectively. In all cases, facility fees predominated (from 59% to 66% of all costs, followed by professional services fees (from 20% to 25%), with smaller proportions going to radiology/imaging, anesthesiology, pharmacy, and laboratory.

Figure 3a and 3b.

Average total maternal-newborn health care payments by type of service among commercial beneficiaries with vaginal (3a) and cesarean births (3b), 2010.
Note: Commercial results are weighted to reflect the national employer-sponsored insurance population. Costs include payments for maternal prenatal, childbirth, and postpartum care and newborn care from birth through three months. Due to rounding, the sum of average payments across categories may not add up to exactly the total average allowed payment.

Figure 4a and 4b.

Average total maternal-newborn health care payments by type of service among Medicaid beneficiaries with vaginal (4a) and cesarean births (4b), 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 payments for maternal prenatal, childbirth, and 3-month postpartum care, and newborn care from birth through three months. Due to rounding, the sum of average payments across categories may not add up to exactly the total average allowed payment.

Tables 2 and 3 present the allocation of all maternal-newborn payments by type of service. Among total average Commercial payments for maternal-newborn care with vaginal births ($18,329), 59% went to facilities and 25% to maternity care providers, followed in descending order by payments for anesthesiology, radiology/imaging, laboratory, and pharmacy services. Among total average Commercial payments for maternal-newborn care with cesarean births ($27,866), 66% went to facilities and 21% to maternity care providers, followed in descending order by payments for anesthesiology, radiology/imaging, pharmacy, and laboratory services. Among total average Medicaid payments for maternal-newborn care with vaginal births ($9,131), 59% went to facilities and 23% to maternity care providers, while among total Medicaid payments for cesarean births ($13,590), 65% went to facilities and 20% to maternity care providers.

For both types of birth, remaining Medicaid payments covered in descending order pharmacy, radiology/imaging, laboratory, and anesthesia services.

Table 2. Average Total Maternal-Newborn Health Care Charges and Payments by Type of Service Among Commercial Beneficiaries with Vaginal and Cesarean Births, 2010

  Total Vaginal Childbirth Cesarean Childbirth
Commercial
Grand Total: Prenatal*lntrapartum+Postpartum+First Three Months of Newborn Care
Total Costs
Provider Charges £37,141 $32,093 £51,126
Allowed Paid Amount £21,001 $16,329 £27,666
Facility Fees
Provider Charges £23,640 $19,664 £34,706
Allowed Paid Amount £12,953 $10,341 £16,359
Professional Anesthesiology Fees2
Provider Charges £1,663 $1,607 £1,931
Allowed Paid Amount £1,037 £990 £1,192
Professional Service Fees
Provider Charges £7,636 $6,607 £9,792
Allowed Paid Amount £4,917 $4,493 £5,957
Laboratory Fees
Provider Charges £1,426 $1,396 £1,521
Allowed Paid Amount £550 £539 $534
Radiology/Imaging Fees
Provider Charges £1,995 $1,392 £2,312
Allowed Paid Amount £1,015 £966 £1,165
Pharmacy Fees
Prouder Charges £765 £730 $669
Allowed Paid Amount £531 £501 $614

Note: Commercial results are weighted to reflect the national employer-sponsored insurance population. Costs include payments for maternal prenatal, childbirth, and postpartum care and newborn care from birth through three months. Due to rounding, the sum of average payments across categories may not add up to exactly the total average allowed payment.

Table 3. Average Total Maternal-Newborn Health Care Charges and Payments by Type of Service Among Medicaid Beneficiaries with Vaginal and Cesarean Births, 2010

  Total Vaginal Childbirth Cesarean Childbirth
Medicaid
Grand Total: Prenatai* Intrapartum* Postpartum* First Three Months of Newborn Care
Total Costs
Provider Changes £35.481 £29,800 £50,374
Allowed Paid Amount £10,350 £9,131 £13,590
Facility Fees
Provider Changes £22,704 £18,376 £34.095
Allowed Paid Amount £6,338 £5,423 $8,793
Professions/ Anesthesiology Fees
Provider Changes £1,015 £876 $1,343
Allowed Paid Amount £172 £165 $138
Professions/ Service Fees
Provider Changes £6,504 £5,656 $8,792
Allowed Paid Amount £2,231 £2,060 $2,694
Laboratory Fees
Provider Changes £2,145 £2,049 $2,371
Allowed Paid Amount £395 £381 $429
Radiology/Imaging Fees
Provider Changes £2,083 £1,902 $2,519
Allowed Paid Amount £517 £475 $616
Pharmacy Fees
Provider Changes £1,056 £950 $1,316
Allowed Paid Amount £700 £627 $379

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 payments for maternal prenatal, childbirth, and 3-month postpartum care, and newborn care from birth through three months. Due to rounding, the sum of average payments across categories may not add up to exactly the total average allowed payment.

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