Rx for healthy babies

The Baltimore Sun

Only 9 percent of babies born in Maryland weigh less than 5.5 pounds, which doctors consider a normal birth weight for healthy infants. Yet that relatively small proportion of infants accounts for more than half of all spending on births in the state - $166.6 million, as opposed to $140 million spent on the other 91 percent of babies, according to a recent study by the nonprofit Advocates for Children and Youth, which lobbies for child welfare issues.

Much of the high cost of low-birthweight infants is born by state and federal governments through the Medicaid program that funds health care for low-income residents.

Babies born with low and very low birth weights cost, on average, 36 times more than normal-weight babies, and they stay in the hospital 15 times longer. In 2007, the average hospital charge for a very-low-birthweight baby (under 3.3 pounds) was $83,995, compared with just $2,308 for a normal-weight baby.

And while advances in neo-natal care have allowed more low-and very-low birthweight babies to survive, they often suffer from serious health problems at birth and lasting disabilities, all of which add to the long-term costs paid for with tax dollars by the government.

Maryland could significantly lower its Medicaid spending for these poor birth outcomes by working to reduce the number of low-birthweight babies born in the state. Since maternal health is a major risk factor, preventive health care programs for women who have had at least one poor birth outcome could help them avoid another. Advocates for Children and Youth estimates that redirecting $4.4 million of current Medicaid spending toward prevention would reduce the state's bill for poor birth outcomes by $5 million a year, saving $600,000.

State legislators this week will review a package of preventive measures that have been proved effective in reducing low-birthweight births. In tough times like these, every dollar saved counts. At the least, the state should institute a pilot program to see whether the projected savings materialize. A preventive strategy aimed at improving birth outcomes among women without regular access to health care could also significantly impact the state's infant mortality rate of eight deaths for every 1,000 live births, one of the highest in the nation.

The savings to Maryland could be substantial, and they shouldn't be counted just in dollars but also in the lives and well-being of its most vulnerable citizens - its children.

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