In the Journals

Out-of-pocket maternity care costs on the rise

Photo of Michelle Moniz
Michelle H. Moniz

Average out-of-pocket costs for maternity care increased by $1,500 between 2008 and 2015 among women with employer-based insurance, according to study findings published in Health Affairs.

“This constitutes a formidable financial burden for many families,” Michelle H. Moniz, MD, MSc, an assistant professor in the department of obstetrics and gynecology at the University of Michigan, told Healio Primary Care.

The increase is due primarily to rising deductibles. Although the Affordable Care Act (ACA), required coverage for preventive services like Pap tests and mammograms, it allowed plans to impose copays, deductibles and cost-sharing for maternity care, Moniz explained.

Moniz and colleagues used a database with information from commercial health insurance plan members and their dependents from 2008 to 2015 to examine out-of-pocket spending for maternity care before and after the implementation of the ACA. Their analysis included data on 657,061 women and 804,089 births

Pregnant Woman 
Average out-of-pocket costs for maternity care increased by $1,500 between 2008 and 2015 among women with employer-based insurance, according to study findings published in Health Affairs.
Source: Shutterstock

Researchers included spending on health care services in the year leading up to delivery, during hospitalization for delivery and 3 months after delivery when calculating total costs for maternity care.

They found that the mean total out-of-pocket spending rose from $3,069 in 2008 to $4,569 in 2015.

During the study period, out-of-pocket costs increased from $3,364 to $5,161 for cesarean births and $2,901 to $4,314 for vaginal births.

Despite these increases, the standardized cost of maternity care remained similar during the study period, costing $29,518 in 2008 (95% CI, 29,374-29,662) and $29,314 in 2015 (95% CI, 29,156-29,472).

Therefore, the average proportion of maternity care costs paid by patients increased during the study period — from 12.3% in 2008 to 19.6% in 2015.

Women with vaginal births paid a greater share of maternity care costs, which increased from 13.6% in 2008 to 21.7% in 2015. The proportion of maternity costs paid by women who underwent cesarean births rose from 10% to 14.6%.

“Financial burdens place women at risk for delaying/deferring maternity care, which increases risk of poor birth outcomes,” Moniz said. “State and federal policies to restrict out-of-pocket spending on maternity care may augment ongoing national efforts to improve maternal-child health outcomes.”

Moniz encouraged patients to be selective, if possible, when choosing a health insurance plan, and to “read the fine print and be wary about high deductible plans.” – by Erin Michael

Disclosures: Moniz reports receiving research funding from the Agency for Healthcare Quality and Research. Please see study for all other authors’ relevant financial disclosures.

Photo of Michelle Moniz
Michelle H. Moniz

Average out-of-pocket costs for maternity care increased by $1,500 between 2008 and 2015 among women with employer-based insurance, according to study findings published in Health Affairs.

“This constitutes a formidable financial burden for many families,” Michelle H. Moniz, MD, MSc, an assistant professor in the department of obstetrics and gynecology at the University of Michigan, told Healio Primary Care.

The increase is due primarily to rising deductibles. Although the Affordable Care Act (ACA), required coverage for preventive services like Pap tests and mammograms, it allowed plans to impose copays, deductibles and cost-sharing for maternity care, Moniz explained.

Moniz and colleagues used a database with information from commercial health insurance plan members and their dependents from 2008 to 2015 to examine out-of-pocket spending for maternity care before and after the implementation of the ACA. Their analysis included data on 657,061 women and 804,089 births

Pregnant Woman 
Average out-of-pocket costs for maternity care increased by $1,500 between 2008 and 2015 among women with employer-based insurance, according to study findings published in Health Affairs.
Source: Shutterstock

Researchers included spending on health care services in the year leading up to delivery, during hospitalization for delivery and 3 months after delivery when calculating total costs for maternity care.

They found that the mean total out-of-pocket spending rose from $3,069 in 2008 to $4,569 in 2015.

During the study period, out-of-pocket costs increased from $3,364 to $5,161 for cesarean births and $2,901 to $4,314 for vaginal births.

Despite these increases, the standardized cost of maternity care remained similar during the study period, costing $29,518 in 2008 (95% CI, 29,374-29,662) and $29,314 in 2015 (95% CI, 29,156-29,472).

Therefore, the average proportion of maternity care costs paid by patients increased during the study period — from 12.3% in 2008 to 19.6% in 2015.

Women with vaginal births paid a greater share of maternity care costs, which increased from 13.6% in 2008 to 21.7% in 2015. The proportion of maternity costs paid by women who underwent cesarean births rose from 10% to 14.6%.

“Financial burdens place women at risk for delaying/deferring maternity care, which increases risk of poor birth outcomes,” Moniz said. “State and federal policies to restrict out-of-pocket spending on maternity care may augment ongoing national efforts to improve maternal-child health outcomes.”

Moniz encouraged patients to be selective, if possible, when choosing a health insurance plan, and to “read the fine print and be wary about high deductible plans.” – by Erin Michael

Disclosures: Moniz reports receiving research funding from the Agency for Healthcare Quality and Research. Please see study for all other authors’ relevant financial disclosures.