Why pay extra for cesarean-section deliveries?
Third-party insurers typically pay at least 50% more for cesarean sections than for vaginal deliveries, suggesting that a reduced national cesarean-section rate could save payers more than $1 billion annually. This paper discusses the payment implications of a cost-effectiveness study, based on the experience within one health maintenance organization, in which cesarean-section rates were unrelated either to direct costs or to perinatal outcomes. Given these results, insurers should consider paying a flat fee for obstetric services unless differing risk levels or risk-adjusted outcomes justify different amounts.
Finkler
M D
MD
Lawrence University, Appleton, WI 54912-0599.
Wirtschafter
D D
DD
D002140:California; D002585:Cesarean Section / Q000191:economics* / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D005249:Fees and Charges; D005260:Female; D006279:Health Maintenance Organizations / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D009775:Obstetrics and Gynecology Department, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D011247:Pregnancy; D012306:Risk