As an organization offering self-insured options to employers, you likely manage some mix of provider networks, quality of care, utilization management, case management, health care analytics, plan administration and more. But what if one of your clients faced a premature or medically complex birth? Do they have access to specialized NICU Care Management?
Infants admitted to a hospital’s Neonatal Intensive Care Unit (NICU) are understood to be those born prematurely or with medical complexities, warranting care that, by definition, is more intensive and also more costly than that provided to a healthy newborn. However, accepting the accuracy of this scenario may lead to a significant misinterpretation regarding your NICU population. Specifically, what happens to your analysis when the care of healthy newborns is being billed as NICU services?
Medical costs for newborns are some of the fastest growing in healthcare - mostly driven by infants requiring NICU services. Such cases represent a small percentage of the newborn population (approx. 15%) but consume a large percent of the total cost of care for this group (>40%). The increasing costs are partially attributed to cases where claims are submitted for the newborn’s NICU admission with a single revenue code level that reflects a higher resource use intensity than is documented in the records for the duration of care, resulting in higher than expected costs to the health plan.
Every August, World Breastfeeding Week is celebrated in more than 170 countries around the globe. It is an annual reminder to improve the health of babies around the world by encouraging breastfeeding. Breast milk is the ideal food for babies. It is an amazing "brain food," containing more than 200 ingredients that are specifically designed to provide the most idealgrowth and development for the human body. Breast milk is rich in nutrients needed by the baby for brain growth and development.