15th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 13-15, 2016 • San Diego, CA
3/14/2016 | 3:20 PM - 3:50 PM | Topical Session 3 | Pacific Salon 4/5 | 9 - Program Evaluation and Quality Improvement
Determining Average Costs Reimbursement for Newborn Hearing Screening Using MarketScan
Successful implementation of state-based Early Hearing Detection and Intervention (EHDI) Programs has resulted in over 95% of U.S. infants being screened for hearing loss. Research has shown that the cost of screening for hearing loss depends on the location (inpatient versus outpatient), provider type, and the screening technology used. Little is known about the current reimbursements for newborn screening for hearing loss. In 2004, the private sector reimbursement for screening for hearing loss in the hospital averaged $84 when billed and paid separately for labor and delivery. Approximately 95% of paid claims in 2004 fell within the range of $0 to $200. However, if the screening was not performed before hospital discharge or had to be repeated in an outpatient setting, the average private-sector reimbursement was higher ($98) with nearly all of the claims falling in the range of $0 and $235. To evaluate current efforts in newborn hearing screening and assess payments, the Centers for Disease Control and Prevention looked at insurance claims data from the MarketScan Treatment Pathways between 2009 and 2014. During this presentation, current newborn screening efforts in both inpatient and outpatient settings will be highlighted along with a summary of reimbursements paid by insurance. Key differences in screening efforts by insurance type will be highlighted to help understand these reimbursements and support improvements in screening services for deaf and hard of hearing children.
- Summarize newborn screening efforts using insurance claims data to identify deaf and hard of hearing children
- Identify differences in screening efforts based on insurance type
- Assess reimbursement for newborn screening among infants with private or Medicaid insurance and compare how much payers are paying when billed separately
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Presenters/Authors
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ThuyQuynh Do
(Primary Presenter,Author,POC), Centers for Disease Control and Prevention, ThuyQuynhDo@cdc.gov;
Dr. Quynh Do is a Prevention Effectiveness Fellow at the Centers for Disease Control and Prevention's National Center for Birth Defects and Developmental Disabilities in the Division of Human Development and Disability. She received her PhD in Sociomedical Sciences from the University of Texas Medical Branch and Master of Public Health from the Virginia Commonwealth University. She works on the Rare Disorders and Health Outcomes and the Early Hearing Detection and Intervention Teams. Prior to CDC, Quynh worked as public health consultant in a wide range of areas including program
management and support, research and evaluation, health promotion and marketing, database administration, survey
development, technical writing, and technical assistance in minority health, occupational health, substance abuse and
mental health, and women’s health issues.
ASHA DISCLOSURE:
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No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.