Employer Health Plans Spend At Least $6 Billion Per Year On Preterm Infant Care

MedicalResearch.com Interview with:

Scott D. Grosse, PhD National Center on Birth Defects and Developmental Disabilities CDC 

Dr. Scott Grosse

Scott D. Grosse, PhD
National Center on Birth Defects and Developmental Disabilities

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The U.S. Institute of Medicine (IOM) in 2007 published estimates of the economic costs associated with preterm birth. That report is publicly available: https://www.ncbi.nlm.nih.gov/pubmed/20669423. The total societal cost over a lifetime of a single year’s cohort of infants born preterm was estimated as $26 billion in 2005 US dollars. The study in Pediatrics sought to provide more current estimates of one component of those costs: medical care between birth and 12 months and to answer two additional questions:

  1. What costs are specifically incurred by employer-sponsored private health plans?
  2. How much of the overall cost burden of prematurity is attributable to infants born preterm with major birth defects (congenital malformations and chromosome abnormalities)?

MedicalResearch.com: What is the background for this study? What are the main findings?

  1. Employer health plans spent at least an extra $6 billion each year in 2013 on medical care during infancy for infants born preterm compared with infants born at term.
  2. As much as 25% of the healthcare costs associated with preterm birth were for infants born preterm with major birth defects.

MedicalResearch.com: What should readers take away from your report?

  1. Preterm birth is costly to healthcare payers, including large, self-insured employers.
  2. Prevention of preterm birth and of birth defects that can predispose infants to be born preterm could substantially reduce healthcare costs.
  3. The true cost of preterm birth may differ from the estimates in this report because billing codes may not reliably identify infants born preterm or with birth defects.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

  1. New studies of costs of preterm birth and birth defects could be conducted in which state-level administrative data on healthcare costs are linked at the level of the individual infant with state population databases that include validated information on weeks of gestational age at birth and diagnoses of major birth defects.
  2. Information on how costs of care for preterm infants vary by weeks of gestational age is needed to calculate the economic benefits of preterm prevention strategies. An intervention that extends gestation by 2 weeks can have very different economic impacts depending on when the birth would have occurred. Hospital costs for infants born at 28 weeks may average 40 times more than for infants born at 36 weeks: https://www.ncbi.nlm.nih.gov/pubmed/16459031

1.    This study was a collaboration between CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD), CDC’s National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health (DRH), and the University of Utah.

2. The second author, Dr. Waitzman, is Chair of the Department of Economics of the University of Utah. He was first author of a 1996 book, The Cost of Birth Defects. As a member of the IOM Committee on Understanding Preterm Birth, he led the preparation of the cost estimates for preterm birth included in that report. He used linked birth certificate-administrative claims data from a large health care system in Utah to generate nationally-weighted estimates of medical costs during the first five years of life.

3. The first author, Dr. Grosse, is the senior health economist in the CDC’s National Center for Birth Defects and Developmental Disabilities, Office of the Director. He previously collaborated with Dr. Waitzman on the IOM report on cost estimates and conducted the data analyses for the study in Pediatrics.

4. The third author, Dr. Yang, served as a postdoctoral Prevention Effective Fellow assigned to CDC’s Division of Reproductive Health.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.


Employer-Sponsored Plan Expenditures for Infants Born Preterm
Scott D. Grosse, Norman J. Waitzman, Ninee Yang, Karon Abe, Wanda D. Barfield
Pediatrics September 2017

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on October 6, 2017 by Marie Benz MD FAAD