|Date Requested:January 31, 2012
Time Requested:01:30 PM
| FUND(S) |
Sources of Revenue
Legislation creates:Neither Program nor Fund
Effect this measure will have on costs and revenues of state government.
| The purpose of this bill is to require each birthing facility licensed by the Department of Health and Human Resources to perform a pulse oximetry screening for congenital birth defects on every newborn in its care, a minimum of 24 hours after birth.
The West Virginia Public Employees Insurance Agency (WVPEIA) currently reimburses WV hospitals for maternity benefits through a Diagnosis Related Group (DRG). At the current time this procedure is included in the DRG for hospitals.
American Health Association journals project the cost of routine pulse oximetry performed on asymptomatic newborns after 24 hours of age includes both the direct cost of the pulse oximetry and the follow-up costs of any additional examinations. The largest direct cost is staff time. At experienced centers, it may take a technician only 45 seconds on average to perform pulse oximetry on a newborn infant. A detailed cost accounting indicates an average cost of approximately $1.00 per asymptomatic newborn infant which includes the cost of diagnostic evaluation, in hospitals with moderate obstetric volume.
The American Academy of Pediatrics predicts the cost of conducting pulse oximetry examination and follow-up is quite low with published estimates of $5.00 or less per infant, up to $10.00 per infant, depending on the protocol. Although screening can sometimes be completed in less than one minute, other studies estimate that the process takes five minutes of staff time, including communication with parents.
There are approximately 1,200 births covered annually by the WVPEIA. Utilizing the $5.00 - $10.00 cost for pulse oximetry, there is a potential $6,000.00 - $12,000.00 increased claim cost. This cost could potentially have the effect to increase future DRG reimbursement to hospitals.
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3. Explanation of above estimates (including long-range effect):