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U.S. Health Insurers Getting Tough Against Non-Medically Indicated Deliveries <39 Weeks

| FPQC

For over 30 years, the American Congress of Obstetricians and Gynecologists (ACOG) has opposed non-medically indicated deliveries <39 weeks gestational age through guidelines outlining the potential risks to the health of the babies. During the last few weeks of a healthy pregnancy, certain vital organs – such as the brain and lungs – are still developing in the womb. When an obstetrician delivers a baby before 39 weeks without medical indication to do so, that baby has a higher chance of a stay in the NICU as well as future potential developmental and behavioral health complications. Despite ACOG’s guidelines, the rate of these types of early deliveries remain at unacceptable levels. The Department of Health and Human Services estimates them to be between 10 and 15% of U.S. babies born every year; and, The Leapfrog Group – an employer driven hospital quality watchdog group – estimates that some hospitals are reaching levels over 40%.

U.S. health insurers finally have realized the incredible, unnecessary expenses these types of deliveries are costing them. Both private and government health insurers are starting to discourage and in some cases penalize doctors and hospitals for delivering babies before 39 weeks when there is no medical indication to do so. Their aim not only is to reduce care in NICUs but also to avoid a wide range of subsequent medical costs arising from potential developmental and learning issues caused by these deliveries. To learn more, please visit The Washington Post.

Written By: Heidi K. Curran, MBA

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