In an analysis of 76,826 patients covered by Blue Cross Blue Shield of Massachusetts, researchers studied the costs of 87,253 maternity episodes, defined as pregnancy, delivery and 42 days postpartum. The data spanned 2018 through 2022.
Here are five findings, which were published in JAMA Health Forum:
1. The mean out-of-pocket spending throughout maternity care was $2,398, $2,300, $2,202 and $2,036 for Black, Hispanic, Asian and white patients, respectively.
2. These disparities in expenses were much more pronounced for prenatal care, including routine obstetrical radiological exams and lab tests, fetal testing and care provided by an OB-GYN. White patients, on average, spent $503 out of pocket for prenatal services. Comparatively, Asian patients spent 6.3% less ($472), Hispanic patients spent 16.9% more ($588) and Black patients spent 32.6% more ($667).
3. Recommended prenatal care services cost Asian patients 4.2% more ($259), Hispanic patients 51.2% more ($376) and Black patients 74.4% more ($434) than White patients ($249).
4. Out-of-pocket costs for delivery and postpartum care saw smaller differences.
5. The largest differences in plan benefit design by race and ethnicity were in coinsurance, suggesting an opportunity to redesign coinsurance policies to address these inequities.
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