MATERNITY STAYS: Mandated Stays Increase Costs In MD
A study of Maryland's hospital discharge data before and after the state enacted the nations' first law mandating that insurers cover minimum maternity stays found that the law "cost payers an additional $5.5 million." Research published in the current issue of Health Affairs indicates that the law requiring "coverage of a minimum of 48 hours of inpatient hospitalization following an uncomplicated vaginal delivery and 96 hours of inpatient care following an uncomplicated cesarean section" increased the average hospital stay. For vaginal births, the length of stay increased 37.5%, from 1.45 days to 1.99 days, and for cesarean births, the length of stay increased 17% from 2.99 days to 3.5 days. The average cost of delivery increased by 10% for vaginal births and by 6.27% for cesarean deliveries. As a result, "Maryland health care payers were charged an estimated $4.7 million more for vaginal deliveries ... or an average of about $250 additional per birth," and the "total additional costs to the system for cesarean deliveries was about $800,000 -- or about $225 per cesarean birth."
Health Affairs reports that the "primary beneficiaries of the legislation were white women between ages 19 and 35, with private health insurance, delivering babies in rural and suburban hospitals." Women not in these categories, but in "higher-risk categories ... usually had longer stays before the law." The study concludes that although "the evaluation will not be complete until evidence is available to assess the effects on health outcomes ... early evidence suggests that the influence of mandatory minimum hospital maternity stays on total system costs, although measurable and significant, is probably not severe" (Udom/Betley, Health Affairs, Sept./Oct. 1998 issue).