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Racial and Ethnic Differences in Out-of-Pocket Spending for Maternity Care.

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Summary
This summary is machine-generated.

Black and Hispanic individuals face higher out-of-pocket maternity care costs due to coinsurance, potentially impacting healthcare access. Health plan adjustments can promote greater spending equity.

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Area of Science:

  • Health Services Research
  • Health Economics
  • Health Equity

Background:

  • Rising out-of-pocket (OOP) costs for maternal healthcare can negatively influence healthcare utilization and patient outcomes.
  • Racial and ethnic disparities in maternal health outcomes are well-documented, yet differences in associated spending remain less understood.

Purpose of the Study:

  • To quantify disparities in OOP spending for maternity care across different racial and ethnic groups among individuals with commercial insurance.

Main Methods:

  • A retrospective cross-sectional analysis utilized administrative data from Blue Cross Blue Shield of Massachusetts (2018-2022).
  • The study examined OOP spending during the entire maternity episode (pregnancy, delivery, 42-day postpartum) stratified by race and ethnicity.
  • Spending was analyzed in total, by period (prenatal, delivery), by cost-sharing type, and as a percentage of median census tract income.

Main Results:

  • The study included 87,253 maternity episodes. Mean OOP spending was highest for Black ($2,398), followed by Hispanic ($2,300), Asian ($2,202), and White ($2,036) individuals (P < .001).
  • These spending disparities persisted after adjusting for health and demographic factors, with the largest differences observed during the prenatal period and attributed to coinsurance.
  • Black and Hispanic individuals were more likely to have plans with high coinsurance rates compared to Asian and White individuals.

Conclusions:

  • Disparities in OOP maternity spending among commercially insured individuals are linked to variations in coinsurance rates.
  • These financial burdens may compel individuals to forgo essential healthcare or other basic needs.
  • Modifications to health plan benefit designs are recommended to enhance equity in OOP maternity spending and mitigate adverse consequences.