FAIR Health recently released the Cost of Giving Birth Tracker, an interactive tool which provides median in-network and out-of-network costs for cesarean and vaginal deliveries in each state. The tool differentiates the charge amount (charge to an uninsured patient or out-of-network) and the allowed amount (fee negotiated between insurance plan and provider for an in-network patient) for each mode of birth and includes professional and inpatient and outpatient facility costs from more than 41 billion private healthcare claims records.
Here is the cost of giving birth in Kentucky:
- The median charge value for cesarean delivery is $31,315.30 (national median: $35,907.33) compared to vaginal delivery at $21,214.50 (national median: $27,371.88).
- The median allowed value for cesarean delivery is $12,769.42 (national median: $15,555.61) compared to vaginal delivery at $9,550.11 (national median: $12,968.44).
The tracker shows us that the median cost of giving birth in Kentucky, both via cesarean and vaginally, is less than the national median cost and one of the lowest in the United States. What it also shows us is that there is wild variability in the cost of giving birth at the state-level though it does not provide insights into why this may be the case. In Alaska, for example, the median allowed charge for a vaginal birth is $21,525.77, almost $12,000 more than the allowed charge in Kentucky.
The Cost of Giving Birth tracker, though, does not capture the true cost of giving birth. It does not, for example, include costs associated with postpartum complications of childbirth like hemorrhage or infections related to surgery. We know that cesarean delivery is associated with significantly higher costs and worse outcomes for moms and babies and that Kentucky has one of the highest cesarean rates in the U.S. In 2022, more than a third (34.5%) of births (52,219) in Kentucky were cesarean deliveries. Of great concern is the high rate of low-risk cesareans in Kentucky (27.3%), which refers to nulliparous (first birth), singleton, head down, term (37 weeks or greater) births.
Likewise, the tracker does not show the non-financial costs of giving birth which can be seen in Kentucky’s maternal mortality rate, one of the highest in the country at 37.7 deaths per 100,000 live births in 2019. Outcomes are even worse for Black women, who die at more than double the rate of white women. It is clear that the cost of giving birth is more than financial.
The Cost of Giving Birth tracker opens the door for deeper consideration and discussion about the variability of childbirth costs across Kentucky and how these costs may be associated with birth outcomes. Could we, for example, examine costs at the hospital-level and discern any difference in birth outcomes? This information might help us develop new ideas and strategies for financial interventions, like blended payment policies, or other interventions that can improve outcomes for moms and infants.
Discussions related to improving outcomes for Kentuckians giving birth are complex and must be considered carefully. Multi-stakeholder perspectives, including the voices of people who give birth and healthcare providers, must be included in the consideration and implementation of strategies. We need more data to understand hospital and regional variation in cost and outcomes across the state to inform these discussions. The Cost of Giving Birth tracker shows that variations in actual charges are significantly different from state to state, providing evidence for addressing policy at a regional or local level.
At KHC, we are considering how we can contribute to the already impactful work happening across the state to improve outcomes for moms during pregnancy, childbirth, and postpartum. We would love to hear from you about the strategies that your organizations and/or communities are thinking about or currently implementing. Reach out to Melissa Eggen at meggen@khcollaborative.org to share!
