Childbirth costs up to $20K in Nashville area

Friday, May 12, 2017, Vol. 41, No. 19
By Vicky Travis

Oh, you’ll forget about the pain once that sweet baby is in your arms.

Well, many moms might debate that. But the truth about childbirth as opposed to many other health events, there’s an unbelievable prize at the end.

What will it cost?

The best answer: It depends.

Factors that play the big roles in the total cost to have a baby include vaginal vs. C-section delivery, where one lives and whether, of course, one has insurance.

The U.S. House of Representatives passed the American Health Care Act May 4. The bill now goes to the U.S. Senate, where it could see major revisions.

The American Medical Association and the American Congress of Obstetricians and Gynecologists oppose the bill.

The ACOG statement about the bill says, in part, “It harms pregnant women and babies by reverting to the years before the Affordable Care Act (ACA) when a woman’s maternity and other essential coverage depended on what state she lived in …We urge the U.S. Senate to reject the AHCA and instead focus on ways to improve our nation’s health and help reduce health care costs.”

The Republican National Committee statement states, in part, that “Republicans are committed to lowering costs, fostering competition in the marketplace, and giving Americans everywhere access to quality and truly affordable healthcare.”

Despite what happens in Congress, personal research is key to figuring cost.

Healthcarebluebook.com reports that $12,689 is its fair price for vaginal delivery in Nashville. Cost ranges from $7,730 at the low end to $20,383 at the highest. Note, this is total cost, not out-of-pocket.

Another source to check is the Healthy Marketplace Index: Medical Service Category Price Index. It compares health care prices for inpatient, outpatient, and physician services, relative to a national average.

The index shows the Nashville area (including Murfreesboro and Franklin) landing squarely in the average cost range relative to a national average. But in the three-year period of 2012, 2013, 2014 prices did increase.

For those with insurance, work to understand the copay, deductible and out-of-pocket maximum to estimate cost.

Realize too, that services will be charged separately.

Bills will likely come from the hospital, the doctor, the anesthesiologist and the radiologist. Also, if paying upfront at the hospital, check later with your insurance carrier to make sure total costs were correct.

New mom Ashley Trusler and her husband got a refund for some of the cost after they learned they’d overpaid.

Guroo.com shows cost estimates that are calculated based on over 758 million insurance claims and their reported negotiated rates.

These sites offer clues to actual cost. It will take more homework. Call the hospital’s or birth center’s billing department to get an estimate of your out-of-pocket amount. The more you know ahead of time, the fewer surprises down the road.

Despite planning, it still depends.

“Cost is highly variable based on a patient’s needs,” says Dr. J. Michael Newton, VUMC director of Labor and Delivery.

Providers such as non-profit University Community Health Services, serves patients with private insurance, no insurance and TennCare.

It accepts non-insured referrals from OB practices that aren’t set up to accept these patients.

Choosing to deliver with a midwife may lower cost, but that’s not the reason most would choose to do so.

“We don’t see cost as why they make their choice,” says Addie Graham, certified nurse midwife.