Insurers avoid C-sections to save costs, cut risk

Many insurers now are working to decrease the amount of cesarean surgeries to help defray the rising healthcare costs and risks associated with the most common surgery in the country.

"We've known the risks of these procedures for a long time, yet the rates continue to rise," Maureen Corry, executive director at advocacy group Childbirth Connection, told Bloomberg. "The payers are finally saying, 'Enough is enough. This is crazy.'"

Not only have C-sections increased to a record 33 percent of U.S. babies delivered in 2009, but induction rates doubled over the past 20 years to 23 percent in 2009. The problem is that C-sections and inductions, which often cut pregnancy short by a few days, are associated with the increased risk of complications, including breathing problems and infection, doubled for babies born at 38 weeks instead of 39 weeks. That risk jumps fourfold for babies born at 37 weeks. What's more, cesarean surgeries earn hospitals as much as twice the rate of traditional deliveries.

To help combat these risks and related costs, Aetna has started adjusting prices for cesareans, renegotiating maternity payments for 10 hospitals so far. It also is calling attention to hospitals--300 so far--that work toward avoiding elective births before 39 weeks, Bloomberg noted.

Cigna is considering providing bonuses for hospitals that reduce early C-sections and inductions, and it has found that by providing doctors and hospitals with research on the benefits of full-term births, C-sections and inductions have decreased. For example, research from the Leapfrog Group showed that hospitals could save up to $1 billion if they reduce or eliminate the early elective deliveries, FierceHealthcare previously reported.

UnitedHealth, meanwhile, is taking "more of a carrot approach," focusing on educational campaigns, including videos and websites geared toward pregnant women, said Tina Groat, UnitedHealth's national medical director for women's health.

To learn more:
- read the Bloomberg article

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