From the Journals

Interventions urged to stop rising NAS, stem Medicaid costs


 

FROM PEDIATRICS


During 2004-2014, the incidence of NAS in the United States increased more than fivefold, from 1.5 per 1,000 hospital births (95% CI, 1.2-1.9) to 8 per 1,000 hospital births (95% CI, 7.2-8.7), as the opioid epidemic worsened in the country.

Infants with NAS who were covered by Medicaid had a greater chance of being transferred to another hospital for care (9% vs. 7%; P = .02) and stay in the hospital longer (17 days vs. 15 days; P less than .001), compared with infants with NAS who were covered by private insurance.

NAS is costly. In the 2011-2014 era, mean hospital costs for a NAS infant covered by Medicaid were more than fivefold higher than for an infant without NAS ($19,340/birth vs. $3,700/birth; P less than .001). After adjustment for inflation, mean hospital costs for infants with NAS who were covered by Medicaid increased 26% between 2004-2006 and 2011-2014 ($15,350 vs. $19,340; P less than .001), the researchers reported. Annual hospital costs, which were adjusted for inflation to 2014 U.S. dollars, for all infants with NAS who were covered by Medicaid rose from $65.4 million in 2004 to $462 million in 2014.

“With the disproportionate impact of NAS on the Medicaid population, we suggest that NAS incidence rates are unlikely to improve without interventions targeted at low-income mothers and infants,” Dr. Winkelman and his associates concluded.

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