Costs rung up in neonatal intensive care units have always been a drain for employer-sponsored health insurance. A new study in Pediatrics narrows the problem down, saying that the sizable amount of money spent on preterm infants in 2013 was spent on those with birth defects.
|Employer-sponsored health plan expenditures on infants during the first year of life, 2013|
|Number||Average expenditure||Aggregate expenditure||Percentage of total expenditure|
|Preterm with major birth defects||893||$226,840||$202,568,433||10.2%|
|Preterm without major birth defects||12,401||$42,620||$528,533,100||26.7%|
|Nonpreterm with major birth defects||3,691||$63,939||$235,998,923||11.9%|
|Nonpreterm without major birth defects||156,532||$6,450||$1,009,562,526||50.9%|
|Source: Grosse SD et al., Pediatrics, October 2017. Data are from Truven Health Analytics MarketScan Commercial Research Database.|
“Infants born with serious birth defects incur much higher costs if they are also born preterm,” the study notes.
Infants with major birth defects accounted for 5.8% of preterm births but 24.5% of the costs incurred during infancy, the study found. The average expenditure for preterm infants with major birth defects was $226,840, compared with $42,620 for those born preterm without major birth defects.
The researchers conducted their study using a Truven database that includes a nationwide sample of claims and other data from employer-sponsored health plans. Extrapolating from the Truven data, they calculated that in 2013, employer-sponsored health plans paid between $6 billion and $14 billion for care associated with preterm births.
The cost of preterm infants may be higher for employer-sponsored plans, noted the team of researchers from the CDC and the University of Utah. Previous research has shown that Medicaid programs pay a third of what employer-sponsored plans do for preterm and low-birthweight infants.