Texas focuses on potential NICU overuse to cut costs

The Texas Health and Human Services Commission is examining how neonatal intensive care units are managed and patients referred as part of a cost-savings campaign, reports the Texas Tribune.

The commission's members are concerned that NICUs in Texas are overbuilt--beds have grown 84 percent since 1998--and that too many pediatric patients are being referred to them, driving up costs. Cutting down referrals could save as much as $36.5 million by the end of the decade.

Practices that will be scrutinized include so-called "convenience" c-sections where the health of the mother or infant is not at risk, and prohibiting payments for elective inductions before the 39th week of pregnancy.

"When we look at the data, it indicates that ... more babies are being put in NICUs than need to be in NICUs," said Commissioner Tom Suehs. He noted that two of his own grandchildren were put in Texas hospital NICUs in the last two years, even though they were normal birth weights and their deliveries were uncomplicated.

However, the Texas Hospital Association counters that NICUs are not being overutilized. Instead, their use is being driven by a high birth rate and low insurance levels that guarantee many new mothers did not receive appropriate prenatal care.

For more:
- read the Texas Tribune article
- read the WTMA article

Suggested Articles

Humana filed suit Friday against more than a dozen generic drugmakers alleging the companies engaged in price fixing.

Medicare Advantage open enrollment kicked off last week, and insurers are taking new approaches to marketing a slate of supplemental benefit options. 

Health IT company Cerner announced a definitive agreement to acquire IT consulting and engineering firm AbleVets as a wholly owned subsidiary.