Premature Births Cost Insurers Up to $14 Billion Annually

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.

“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.