Cost of Cleft Team Care at an Academic Children’s Hospital

Abstract

Background

The financial burden of cleft-craniofacial team care is substantial, and high costs can hinder successful completion of team care.

Solution

Collaboration with multiple stakeholders including providers, insurers, and patient guardians, as well as hospital administrators, is critical to increase patient retention and improve final clinical outcomes.

What We Do That is New

At our cleft and craniofacial center, charges for a team care visit fall into one of three categories—hospital fees, professional fees, or external fees. There are four types of hospital fees depending on (1) whether the patient is new or returning, and (2) whether the patient saw ≤4 or ≥5 providers. To further elucidate the financial burden (out-of-pocket costs) directly borne by families of children with cleft lip and/or palate, we conducted a retrospective review of billing records of team care visits made between September 2019 and March 2020. Out-of-pocket costs for a single team care visit (on a commercial insurance plan) ranged from $4 to approximately $1220 and had a median (IQR) of $445 ($118, $749).