Unaffordable Utah: ‘Unsustainable’ Baby Delivery Costs

SALT LAKE CITY, Utah – Welcoming a bundle of joy is now leaving families with a bundle of bills as out-of-pocket baby delivery costs for maternity care have increased nearly 49% in recent years, according to a new study from the journal Health Affairs.

The study found that the amount women paid — after insurance paid its portion — for delivering a baby jumped from $3,069 in 2008 to $4,569 in 2015. The surge is mostly blamed on increases in deductibles.

“It’s hurting real people,” said Stacy Stanford, a policy analyst at the Utah Health Policy Project. “Deductibles have gone up and up over the years. Premiums are going up. Copays are even going up.”

The insurance industry calls in cost-sharing. It’s a way of passing more of the skyrocketing health care costs on to consumers, Stanford said.

Guessing Game

“It’s unsustainable,” Stanford went on to say. “The transparency is just not there. It’s really impossible to know how much you’re going to pay ahead of time.”

The trend is leaving families guessing as to what they’ll have to fork over.

“Crazy amounts of stress,” said Springville resident Kaeley White. “A lot of nights up worrying and, ‘How are we going to do this?’”

After hours of talking with her insurance company, doctor and hospital, White’s calculated what she’ll pay $8,550 for the birth of her second child — and that’s with insurance.

“It’s really hard to get your true total,” White said. “You don’t know how things are going to turn out, and there’s a lot of what-ifs.”

White and her husband are slowly adding thousands of dollars to a savings account, and they say the hefty price tag has forced them to put house hunting on hold.

“Insurance becomes just this, ‘Oh if something terrible, terrible, terrible happens,’” White said. “There needs to be more of a concern about how much the everyday person is paying and if it’s fair.”

Baby Delivery Costs Vary Widely

According to a 2015 survey by the International Federation of Health Plans, the average delivery in the U.S. now costs $10,808. While an analysis by FAIR Health puts the national average price tag higher: $12,290.

“You can expect when you have a baby to receive at least seven or eight bills and possibly more,” said Sterling Petersen, the analytics lead over healthcare statistics at the Utah Department of Health.

Petersen says baby bills are all over the map.

“Not only is there variation between hospitals, but within the hospital there’s variation,” he said.

He showed KSL the latest health claim information from the All-Payer Claims Database for regular deliveries without complications. Here’s a sampling of the median charges:

• Panguitch, Garfield Memorial Hospital: $10,208
• Tremonton, Bear River Hospital: $8,074
• Salt Lake City, University of Utah: $7,894 and St. Mark’s Hospital: $6,677
• St. George, Dixie Regional Medical Center: $6,135
• Orem, Timpanogos Regional Hospital: $5,630
• Murray, Intermountain Medical Center $4,819
• Tooele, Mountain West Medical Center $2,539

These totals are just for the hospital bill. It doesn’t count the OB-GYN, anesthesiologist or pediatrician.

“It’s tricky,” Petersen said of determining the final bill. “That’s what it comes down to: it’s just a tricky business right now.”

Delivery Options

Is there a way to save money? One mother of three says she saved thousands of dollars by opting to deliver out of the hospital.

“I knew that I could have a birth that cost less than that $4,000,” said Lehi resident Alyssa Giles.

After giving birth in the hospital for her first two children, Giles decided to have her third baby at a birthing center.

“You get to choose,” she said. “You get to ask the price.”

Unlike a hospital, where you’re stuck with only in-network choices from your insurance, Giles says birthing centers give you the opportunity to shop around.

“You know exactly how much you’re paying,” she said.

She paid a $3,000 flat fee instead of using her insurance, which had a $4,000 deductible and then co-insurance.

Even though she chose to pay out of pocket, her health insurance was still a back-up plan in case of complications that required hospitalization.

Giles says a birthing center isn’t for everyone, but that she prefers it — even choosing to head home two hours after delivery.

“I had put my kids to bed before I went into labor, went and had the baby, came back, they woke up and their baby sister was there,” she said.

She wishes that more insurance companies covered birthing centers and encourages other moms to look at the option in consultation with their medical providers.

“I would say definitely explore it,” Giles said.

Plan Ahead

To understand and control costs, the experts say to:

• Research your insurance plan and get the amounts for your deductible, copays and co-insurance.
• Pay attention to when your deductible resets and understand that your baby will have his or her own deductible.
• Check with your insurance company about your yearly out-of-pocket maximum, which can be as high as $16,000 for a family. This is an important number to know in case mom or baby require specialized care or extended hospitalization.
• Make sure all doctors are in network, including the anesthesiologist and pediatrician.
• Check if you’re eligible for Medicaid.
• Evaluate self-pay discounts at hospitals.