What does it cost to have a baby in the United States? The answer has fundamentally changed as of today: July 1st, 2024.
This question has always vexed me. I've tried unsuccessfully to prospectively price deliveries for others over the years with Price Is Right-like guesstimates of accuracy. Deliveries are expensive - anywhere from a couple hundred dollars, to a couple thousand, to over $10,000 depending on insurance and the complications (or lackthereof) of the birth. With 3.6 million babies born last year in the US, you might think we as a country should have this one figured out. We don't.
About 67% of births in the US are normal vaginal deliveries. The remainder, generally, are C-Sections without major complications. Finally, there is a long tail of complex deliveries and NICU stays that require other clinical and insurance resources to kick in.
Today, thanks to much needed updates in hospital price transparency regulations, the math for families welcoming babies gets a bit simpler. It's up to innovators to turn this new data into pre-visit, bedside, and post-visit experiences for patients that rival buying a flight on Kayak or booking a stay on Booking. com. Here are the main updates:
✔New data points emerge that make it easier to separate "no-nonsense pricing" from "complex math pricing." Patients, given the right tools, can opt for no-nonsense pricing experiences when they value peace of mind.
✔New fields make it easier to compare payer and plan types, simplifying the ability to match prices to insurance cards.
✔The new data format makes it leaps and bounds easier to enforce transparency compliance at a national level, leading to fewer gaps in data.
Most importantly, sunlight continues to act as the best disinfectant. With the veil lifted on the math itself, hospitals and insurance companies can compete on pricing simplicity.
What could it look like to offer an all inclusive delivery rate, regardless of professional fees, delivery method, or days in the hospital?
What could it look like to inform a patient bedside that their stay is already included in a flat rate and they don't need to sweat every last charge?
What could it look like to empower patients bedside to make basic cost-benefit decisions when they can save money with little to no risk on outcomes?
How much could hospitals save if they didn't have to go after patient collections for bills sent weeks and months post-encounter?
How would trust improve between patient and provider if the only mail received post-encounter was a congratulations card from the clinical staff?
Before July 1st 2024, we could glimpse the potential for this type of patient experience but the math was still too fuzzy. Now, with higher resolution data available thanks to years of regulatory work and advocacy, it's time for Turquoise Health and others to step up for the 3.6M families that go through childbirth in the US every year.