Related Experiment Video
Updated: Jun 13, 2025
A Test Bed to Examine Helmet Fit and Retention and Biomechanical Measures of Head and Neck Injury in Simulated Impact
Published on: September 21, 2017
Treatment of Plagiocephaly With Orthotic Helmets: Prevalence, Costs, and Inequities in Massachusetts
Jacob J Wood1, Quynh Anh Phan1, Jaime Phan2
1University of Massachusetts Chan Medical School, Worcester, MA.
Insights
Infant positional plagiocephaly treatment with helmets is declining, especially in medically underserved areas (MUAs). Public insurance offers favorable outcomes with lower costs and fewer claim denials for this condition.
Area of Science:
- Pediatric Health
- Craniofacial Development
- Health Services Research
Background:
- Positional plagiocephaly is a common infant condition caused by sustained head pressure.
- Orthotic helmet therapy is a primary treatment for moderate to severe cases.
- Understanding treatment disparities and costs is crucial for equitable care.
Purpose of the Study:
- To analyze positional plagiocephaly treatment prevalence and costs.
- To assess treatment inequities between medically underserved areas (MUAs) and non-MUAs.
- To evaluate trends in helmet therapy over a six-year period.
Main Methods:
- Utilized health insurance claims data (2016-2021) from Massachusetts CHIA.
- Compared treatment rates, costs, and claim denials between MUAs and non-MUAs.
- Analyzed trends in orthotic helmet therapy prescription and insurance coverage.
Main Results:
- Overall helmet therapy use was 4.3%; MUA patients received treatment less frequently (2.9% vs. 5.2%).
- A significant decline in helmet therapy prescriptions occurred from 2016-2021.
- Public insurance had $0.00 copay and lower denial rates (1.1%) compared to private insurance ($559.8 copay, 3.8% denial).
Conclusions:
- Significant disparities exist in positional plagiocephaly helmet treatment, particularly affecting MUAs.
- Treatment rates have declined over time, raising concerns about access to care.
- Public insurance provides more equitable and affordable access to orthotic helmet therapy.
Abstract:
Positional plagiocephaly is a craniofacial condition resulting from infant positioning that applies pressure consistently to a part of the skull. This study analyzed the prevalence of, and costs associated with orthotic helmet treatment for positional plagiocephaly and assessed inequities in treatment between medically underserved areas (MUAs) and non-MUAs using health insurance claims data from the Center for Health Information and Analysis (CHIA) in Massachusetts for the years 2016-2021. The mean percentage of patients receiving orthotic helmet therapy was 4.3% (SD=0.49, 95% CI=3.88-4.91, P =0.44). MUAs contained 37.2% of patients with positional plagiocephaly and 2.9% of MUA patients were treated with helmets compared with 5.2% of non-MUA patients ( P <0.01). There was a significant decline in the percentage of patients prescribed helmeting therapy over the course of the study ( P <0.01). The average copay amount for public insurance was $0.00, and for private insurance, it was $559.8 (SD=160.7, 95% CI=529.1-590.5, P <0.01). Of 3295 claims for orthotic helmet treatment, 92 were fully denied (2.8%). Private insurers issued more fully denied claims (3.8%) than public insurance (1.1%) ( P <0.01). We found that public insurance is favorable for patients seeking treatment due to a lower likelihood of full denial and lower copayments. In addition, we found that there is a significant disparity in the prevalence of helmet treatment in MUAs, and the percentage of patients treated with helmeting therapy has declined over time.
