In 2021, employer healthcare costs skyrocketed, with maternity costs as the first or second largest drivers. Likewise, out-of-pocket spending on fertility and maternity care has also risen significantly. Reducing maternity costs, and the financial burden they pose to employees, is a top priority for employers as inflation continues to rise. What can employers do to mitigate and control maternity costs? The first step is understanding the factors that drive them.
Why is it so expensive to have a baby in the U.S.?
Having a baby can be an emotionally and physically challenging experience. For many birthing people in the U.S., even those with insurance coverage, paying for it adds an additional layer of stress. A recent analysis by KFF found that people who give birth are, on average, paying over $3,000 in out-of-pocket expenses after giving birth.
There are a number of reasons why birth care is so expensive in the U.S., including:
- Limited access to maternity and reproductive health care
- High deductible health plans
- Increased number of C-sections
- Poor mental health support
- Limited prenatal care
- Lack of fertility coverage
The factors driving high maternity costs in your business
As healthcare spending rises, it’s crucial to understand where costs are going up—and moreover, why. Many self- and fully-insured companies report maternity and childbirth as one of the top spending categories among their employees. But what does that really entail? What factors are driving high maternity costs?
Fertility treatments are quickly becoming a crucial part of reproductive healthcare for the one in 12 couples affected by infertility each year, as well as members of the LGBTQIA+ community and single parents by choice. However, they’re notoriously expensive and shrouded in anxiety and misinformation. A single cycle of IVF can cost up to $30,000, and KFF finds that the average out-of-pocket cost for fertility treatments is above $10,000. For employers who cover fertility expenses, high costs of treatment drive up their costs as well, especially since many people require multiple rounds of treatment.
In the U.S.,one in ten babies are born early. Preterm birth rates are higher among Black birthing parents. The March of Dimes estimates preterm birth affects 11% of babies covered by employer-sponsored healthcare. In addition to the emotional and physical trauma faced by the family, preterm babies are some of the most expensive patients in all of pediatrics. A landmark 2007 study found that preterm babies accounted for $26.2 billion in healthcare expenditures, or over $51,000 per infant.
Since 1990, the rate of C-section use has tripled, outnumbering vaginal deliveries in several regions around the world and exceeding the rate scientists consider “optimal.” As a surgical procedure, C-sections are inherently risky, and can lead to a variety of complications for both the birthing parent and the baby. Because of this, lowering C-sections is quickly becoming a top priority for healthcare organizations. On average, C-sections cost over $5,000 more than vaginal births, notwithstanding the cost of additional complications.
Lack of preconception/prenatal care
Preconception and prenatal care can have a huge impact on outcomes and costs, ensuring a birthing person is well-positioned to have a healthy and successful pregnancy. However, access to adequate prenatal care is inequitable: over 50% of U.S. counties lack a single OB-GYN, and restricted or limited access to contraception services disproportionately affect members of historically marginalized communities. A lack of access to preconception and prenatal care increases the risk of pregnancy loss and other dangerous complications.
Poor mental health
Maternal mental health can have a huge impact on costs before, during, and after childbirth. Perinatal mood disorders (PMD) like postpartum depression and anxiety affect one in eight women around the world, and untreated mood disorders cost the U.S. economy over $14.2 billion annually. Likewise, birthing people with PMDs have 90% higher healthcare costs than those who don’t.
Controlling maternity costs in the workplace
Although the role of HR is changing, fixing a broken healthcare system isn’t (yet) in an HR leader’s job description. That being said, there are ways to help control and mitigate pregnancy costs through proactive benefits and policies that help employees access critical care throughout their family-building journey. The best way to help lower long-term maternity costs is to improve the quality and delivery of care to your employees.
Healthcare organizations often struggle to adapt care to meet people where they are. Personalized care, which takes a holistic approach to each individual based on their physical, mental, social, and economic needs, can help all people find the right support—and right providers—for their unique circumstances. You can deliver personalized care to your employees by working with a vendor like Maven who can tailor the member experience through culturally-competent care and clinically-vetted, personalized content.
One of the biggest gaps in maternity care today is a lack of access, fueled bysystemic racism and discrimination. Because of this, many people, and especially members of Black, Latine, and Indigenous communities, do not seek or receive treatment for chronic or underlying conditions before they start building families. Early engagement programs can ensure your employees connect with their providers early and often, whether they’re making plans, pursuing conception, or raising their families.
Virtual access to specialists
Long wait times impact the healthcare system across the board. But parents, whether expecting or raising their kids, often need assistance from a specialty provider in a matter of hours, not weeks or months. Providers like doulas, nutritionists, fertility educators, and more are often only available in certain geographic areas, and only covered by certain employee health plans. Offering a telehealth solution can help break down those barriers, empowering your employees to speak to specialists when they need it and avoiding worse healthcare outcomes that can result from long wait times and limited access.
Maven helps lower maternity costs with unmatched care
Maven is the leading global digital health platform for reproductive and family health that helps companies provide high-quality, comprehensive support for their employees as they pursue parenthood and beyond. Our holistic care model offers wraparound support through personalized care teams, dedicated care advocacy, and evidence-based care management programs to help drive better outcomes and lower costs for your employees.
To learn more about Maven’s clinical approach and ROI, read how we work with Zynga, a global leader in interactive entertainment, to improve clinical outcomes like C-sections and NICU stays.
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