Employer-sponsored health plans spent an estimated $6 billion extra on infants born prematurely in 2013, and a substantial portion of that was spent on infants with major birth defects, according to a new study.
Birth defects affect one in 33 babies and are a leading cause of infant mortality in the United States. More than 5,500 infants die each year because of birth defects. The babies who live with them are at increased risk for developing lifelong physical, cognitive and social challenges that affect families and place additional financial burden on the healthcare system.
The study, by researchers at the University of Utah and the Centers for Disease Control and Prevention and published in the journal Pediatrics, showed evidence of a substantial burden on insurers due to premature births, as well as the challenges in assessing the potential financial benefit of new interventions to prevent early births.
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About one in 10 infants in the U.S. are born prematurely -- at less than 37 weeks' gestation -- which affects survival and quality of life, according to the study. While many infants are healthy despite not being full term, a small percentage of premature infants who survive require extraordinary and expensive medical care that can extend beyond infancy.
The researchers found that employer-sponsored plans included in the study spent about $2 billion on care of infants born in 2013. Of that, just over one-third was spent on 8 percent of the infants born prematurely.
The data showed infants with major birth defects accounted for less than 6 percent of the premature births, but a quarter of expenditures.
"The contribution of this study is to start to tweak out the contribution of birth defects to that overall cost burden so we can start to prioritize efforts at prevention of both preterm births and birth defects," said Norman J. Waitzman, professor and chair of the Department of Economics at the University of Utah, and an author of the study, in a statement. "This is a multi-billion-dollar burden. In order to prioritize interventions, we have to have an accurate estimate of what the costs are and how those are broken down because often times interventions are tailored to specific populations."
The researchers also said more studies are needed that link vital records, birth defect data and administrative data to refine the per-infant costs of preterm births and interaction of preterm births of infants with major birth defects. Utah, which has the highest birth rate in the nation, is an ideal location for that additional work because of the feasibility of linking the Utah Population Database with the state All Payer Claims Database, the authors said.
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Email the writer: jeff.lagasse@himssmedia.com