High maternity costs hit Black and Hispanic patients hardest: study
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Black and Hispanic people paid more in out-of-pocket costs for maternal care than Asian and white people with the same commercial insurance, a new study published in JAMA Health Forum found.
Why it matters: Black mothers in the U.S. face a pregnancy-related death rate that is more than three times the rate for white mothers. About 80% of these deaths are preventable. The maternal mortality rate for Hispanic women is similar to that of white mothers but has surged in recent years.
- The cost burdens of maternity care may exacerbate those significant racial disparities, the researchers say.
What they did: The study looked at pregnancy, delivery and postpartum care claims data from patients insured by Blue Cross Blue Shield of Massachusetts from 2018 through 2022.
- Among nearly 77,000 unique enrollees who gave birth, almost 79% were white, roughly 10% were Asian, about 8% were Hispanic and about 4% were Black.
- Blue Cross Blue Shield of Massachusetts undertook the research along with academics at the University of Maryland and Harvard to establish a baseline as they try to design solutions for more equitable care, co-author Mark Friedberg, senior vice president of performance measurement and improvement at Blue Cross, said in a news release.
What they found: Black enrollees spent an average of $2,398 in total out-of-pocket spending for maternity care, between their deductible, copayments and coinsurance — or the amount an enrollee pays after they've hit their deductible.
- Hispanic enrollees paid $2,300, while Asian enrollees paid $2,202 and white enrollees $2,036, on average.
Zoom in: Cost differences were especially pronounced for prenatal care, with Black enrollees paying 74% more than white people, the researchers found. Prenatal care is important to help avoid complications during birth.
- Levels of copayments were similar across all groups, and deductibles were slightly lower among Hispanic and white enrollees.
- But coinsurance payments differed significantly.
- Black enrollees paid an average of $772 for coinsurance and Hispanic enrollees paid an average of $779. Asian enrollees paid an average $669. White people paid an average of $511.
The bottom line: Reducing coinsurance rates could make maternity care more accessible and, in turn, reduce maternal health disparities in the U.S., the researchers write.
