title: Covering the costs of care in neonatal intensive care units.
abstract: The continued rise of health care costs, despite private and governmental control efforts, has sustained cost containment as a central issue for health care researchers and policy makers. In keeping with these concerns, the Florida Health Care Cost Containment Board conducted a study of neonatal intensive care units (NICUs) in Florida to ascertain the costs, charges, and net revenues associated with NICU services in individual hospitals, to document cost shifting and cross-subsidization as a means of financing NICU care for indigent populations, and to assess the fiscal impact of NICUs in state-sponsored vs non-state-sponsored Regional Perinatal Intensive Care Center hospitals providing NICU care. Hospitals in the state-sponsored program reported a loss of approximately $16.5 million in contrast to the non-state-sponsored hospitals, which reported a gain of $1 million. Payment being generated by private-pay patients amounted to almost 60% of total revenues but constituted less than one third of the costs in state-sponsored hospitals, indicating a high level of cost shifting. Government support of state-sponsored NICUs, while substantial, has been insufficient; increasing constraints on this funding source would likely worsen the deficit and increase the necessity of cost shifting.
authors.affiliation: Institute for Health and Human Services Research, Florida State University, Tallahassee 32310.
authors.forename: A W
authors.initials: AW
authors.lastname: Imershein
authors.forename: C
authors.initials: C
authors.lastname: Turner
authors.forename: J G
authors.initials: JG
authors.lastname: Wells
authors.forename: A
authors.initials: A
authors.lastname: Pearman
mesh_terms: D000720:Ancillary Services, Hospital / Q000191:economics; D003361:Cost Allocation; D003953:Diagnosis-Related Groups; D005380:Financing, Government; D005431:Florida; D017048:Health Care Costs; D006783:Hospitals, State / Q000191:economics; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000191:economics*; D007902:Length of Stay / Q000191:economics; D010343:Patient Admission / Q000191:economics