Friday , January 17, 2014 - 1:45 PM
The cost of having a baby in an American hospital has tripled since 1996 and charges can vary by tens of thousands of dollars.
Researchers at the University of California at San Francisco showed charges for a normal vaginal delivery in the most populated U.S. states can range from $3,296 to $37,277 and $8,312 to $70,908 for a cesarean section without complications. Institutional and market factors could only explain 35 to 36 percent of the variation in charges, according to the study.
“The market doesn’t work and the system doesn’t regulate it, so hospitals can charge what they want,” said Renee Hsia, lead author of the study. “the scary thing is, as patients, you don’t have this information.”
The California study has caused health advocates nationwide to demand more transparency in the industry, where they say pricing variables are mostly opaque. The U.S. Centers for Medicare and Medicaid Services shows hospital charges for the same procedures vary by thousand of dollars, even within the same city.
In Utah, the numbers also vary depending on which hospital is used, but those figures aren’t as scary compared to those across the nation, said Jill Vicory, Utah Hospital Association director of community affairs.
“Even though we have had some increases over the years, Utah continues to have some of the lowest costs in the country,” she said. “We are still 30 percent lower than the national average.”
Birth costs in Utah vary, depending on which hospital you choose. At McKay-Dee Hospital, a normal vaginal delivery in 2011, the last available figures from the state, averaged $5,194. At Ogden Regional Medical Center, the cost was $6,174. Davis Hospital and Medical Center charged $7,111. Logan Regional Medical Center costs were $4,351, Brigham City Community Hospital, $5,055 and Lakeview Hospital, $6,422.
For a C-section without complications, the costs were $11,827 at Brigham City Community Hospital, $9,793 at Davis Hospital, $9,757 at Lakeview Hospital, $7,229 at Logan Regional, $8,989 at McKay-Dee and $14,000 at Ogden Regional.
Vicory said the reason for the variety in costs depends on several things
“Length of stay is one significant factor. Patient mix and insurance contracts can also contribute to variation in costs,” she said.
Brent James, chief quality officer at Intermountain Healthcare and executive director of Intermountain Healthcare’s Institute for Health Care Delivery and Research, said pregnancy, labor and delivery leadership has focused on the induction of early labor as a target for improvement.
About 15 years ago, Intermountain noticed a striking trend that was part of a larger national phenomenon. Women and their doctors were more frequently choosing to induce labor and increasingly, those inductions were happening at 37 or 38 weeks gestational age.
“We were concerned that early inductions might have negative health consequences for babies and moms,” he said.
This led to efforts to implement guidelines to reduce elective inductions before 39 weeks, which is the ideal gestational period. In 1999, approximately 28 percent of all inductions at Intermountain’s hospitals occurred before 39 weeks. Today, that percentage is under 2 percent. And with the significant drop in early elective inductions, Intermountain has also seen a drop in the average length of labor, fewer C-sections, and a reduction in certain newborn complications in electively induced patients.
As a result, Intermountain is now able to deliver about 1,500 additional newborns each year without any additional beds or nurses. The organization delivers more than 33,000 per year.
“The protocol also reduced admission rates to our newborn intensive care units, reducing their costs as well,” James said. “We estimate that the Intermountain elective induction protocol reduces health care costs in Utah by about $50 million per year. If applied nationally, it would lower health care delivery costs by about $3.5 billion annually.”
University of Utah Hospital had the highest cost for a normal vaginal delivery at $7,788. For an uncomplicated C-section, the highest cost was $14,579 at Pioneer Valley Hospital.
Sign up for e-mail news updates.