Opioid epidemic: Medicaid spent $2 billion excess over a decade on neonatal abstinence syndrome
The problem has only gotten worse, and increasingly expensive, in recent years as more and more infants are born with opioid withdrawal symptoms.
In the United States, one infant is born every 15 minutes with withdrawal symptoms after being exposed to opioids before birth, according to a new study published in the journal Pediatrics. And from 2004 to 2014, the rate of U.S. infants diagnosed with opioid withdrawal symptoms, known as neonatal abstinence syndrome, or NAS, increased 433 percent, from 1.5 to 8 per 1,000 hospital births.
The increase was even more stark in state Medicaid programs -- rising from 2.8 to 14.4 per 1,000 hospital births. Medicaid covered more than 80 percent of NAS births nationwide in 2014.
The study, "Incidence and Costs of Neonatal Abstinence Syndrome Among Infants with Medicaid: 2004-2014," was a collaborative effort among researchers at Vanderbilt, Hennepin Healthcare in Minneapolis and several other institutions. It's the latest in a series of studies exploring the health and financial impacts of NAS and opioid use during pregnancy.
For Medicaid-covered infants, the healthcare costs associated with caring for NAS totaled $462 million in 2014 alone, researchers found. While other studies have shown a high incidence of NAS among Medicaid-enrolled infants, the authors say this is the first to quantify the incidence difference between Medicaid and privately insured infants over time.
Over a 10-year period, NAS resulted in about $2 billion in excess in Medicaid costs, the data showed.
Neonatal abstinence syndrome has been linked to use of both illicit opioids such as heroin and legal opioids like Vicodin. Many infants exposed to opioids during pregnancy will experience withdrawal symptoms shortly after birth. Infants experiencing opioid withdrawal are irritable, can have feeding and breathing problems and are more likely to be born with low birthweight.
Infants with NAS enrolled in Medicaid were significantly more likely than infants without NAS enrolled in Medicaid to be male and reside in poor, rural counties. They were also more likely to be transferred to another hospital for care and have longer hospital stays. The authors concluded that the continued growing incidence of NAS, particularly among infants covered by Medicaid, presents an opportunity to implement policies that improve opioid use disorder treatment for women before, during and after pregnancy.
They also said that Medicaid programs could promote standardization of clinical protocols to reduce hospital costs and improve outcomes for infants with NAS.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
