Prematurity Awareness Month may be ending, but premature births persist every day in this country. In fact, each year 360,000 babies are born too soon. And every day, two moms die from pregnancy-related causes in the U.S.
According to the March of Dimes (MoD), approximately 1 in 10 infants are premature, both in the US and worldwide, although the US has one of the highest preterm rates among first world countries. Although the preterm birth rate declined 1% in 2020, from 10.2% in 2019 to 10.1% in 2020, racial and ethnic differences in preterm birth rates remain. In 2020, the rate of preterm birth among African-American women (14.4%) was about 50 percent higher than the rate of preterm birth among white or Hispanic women (9.1% and 9.8% respectively). In addition, premature birth complications are the leading cause of death for children under the age of five. These infants also have increased rates of developmental delays, potentially needing additional resources during their school years.
The direct costs of medical care for prematurity are significant in terms of hospital expenses for stays in the Neonatal Intensive Care Unit (NICU). A report from Sun Life found that among the top ten conditions for million-dollar stop-loss claims, NICU-related costs appeared at positions three and six, but other factors like workplace absenteeism and delivery of special education services should also be taken into account. The 2019 MoD Report Card estimated the societal cost of a preterm birth at $65,000.
Here’s the good news: more of these babies are surviving, even in extremely premature births, and are going home sooner. To date, Curtis Means, an Alabama boy born 132 days premature on July 5, 2020 –who just reached 16 months old – has been certified as the world’s most premature baby to survive. Despite this happy outcome, the indirect costs of extended NICU stays to parents, employers, and society at-large are often overlooked.
A 2016 paper authored in Europe detailed the many impacts a premature birth has on families, from the maternal medical issues that often necessitate an early birth to resolve significant threats to both mother and baby’s health, to the psychological trauma and post-traumatic stress type symptoms that parents suffer from having such dramatic disruptions to their world. Traveling to the hospital to visit their infant; not being able to hold their baby right away to give the skin to skin contact that aids infant development; time away from other family members; missing work or being less productive while thinking of their struggling infant; and feelings of having no control over the situation leading to anxiety, depression, guilt and anger -- all are psychological burdens that result from having a child in the NICU.
The financial costs of the absenteeism and presenteeism to the employer, in addition to the billions in medical costs, cannot be ignored either.
If you’re a leader at a large company, you’ll likely find many employees who’ve been touched by premature births. And if you truly consider your workforce to be family, you can prove it during these stressful life events. ProgenyHealth’s comprehensive, physician-developed program can help reduce these very expensive NICU claims costs while facilitating a productive return to work for impacted employees at the appropriate point.
Our utilization management programs, aided by our proprietary platform and highly skilled, experienced NICU clinicians, help ensure delivery of the right care, at the right time, in the right place, without excess cost to the payer or adverse outcomes for the infants. Our case management staff connect with families early in the NICU stay, and remain in touch throughout the first crucial months of life. Our team provides education, emotional support, and resources to the mom, caregivers, and family in order to reduce their stress and empower them to meet their infant’s needs post-discharge.
Our experience serving this vulnerable population for nearly 20 years has demonstrated that NICU infants need highly specialized clinical care coordination and the broader support of an extended “family”. By partnering with ProgenyHealth, health plans, as well as employers and their TPAs, have a real opportunity to make that happen, and help these vulnerable newborns achieve healthy outcomes.