I have found myself walking through hospital hallways for many years now. Healthcare finance has led me to interact with department managers across all service lines. From cardiopulmonary rehab to the neonatal intensive care unit, I have probably crunched the numbers and dollars at some point.
But those are just numbers. Until now, the growing Max Out of Pocket crew has not actually needed to use the healthcare system all that much. That’s a good thing. It is usually scary things like illness and injury that launch people into the “system.”
But that all changed when our baby boy arrived a few weeks ago.
Having a baby is different than your typical illness or injury. Touchy-feely emotions like joy and amazement are tied to an experience like this. We were lucky enough to get both. And for us, there was intent and planning behind this special interaction with the healthcare system. For me, it was nice seeing things through a different lens. From a fancy whirlpool to the tasty breakfast sandwiches and name-brand coffee delivered right to our room, I was quite amazed at our luxurious hospital experience.
Unfortunately, things can change on a dime. The Max Out of Pocket crew found ourselves briefly dipping our toes into the scary side of things. Thankfully, little Max and mommy are home now happy and healthy!
Family Birthing Center
We chose to have our baby at a family birthing center. It’s a smaller unit embedded in our small community hospital. There are plenty of other options, such as home birth, but we decided to go the more traditional route. This particular birthing center has an excellent reputation, and we had heard great things about it leading up to our delivery.
It certainly lived up to the hype.
The birthing center is located just two short miles from our house. This location made the odds of Max getting lost on the way to the hospital near impossible. So when Mrs. Max OOP’s water broke on April 27th, and they gave us the green light to come in, we were there in no time.
As for amenities, our spacious suite came with a whirlpool tub, a small kitchenette, and comfortable furniture. We each got a water bottle with “mommy” and “daddy” handwritten on its lid. Small things like this go a long way. There was even cable television and free Wi-Fi.
They positioned the birthing center strategically right down the hall from the operating room. That way, if a natural delivery is not possible, there is easy access to those types of resources. The unit offered nitrous oxide, but we didn’t need to use it. Trust me, it wasn’t because it cost $5,000.
Mothers are amazing. I will never fully understand the effort that goes into labor, but I do know Mrs. Max OOP earned the title of superhero that day. I won’t get into specifics here, but she had a longer than usual labor process. The delivery included an epidural and eventual cesarean delivery.
What I will say is the nurses and OBGYN supported us the entire time. It was amazing to watch this team work together. They kept us informed and encouraged us both along the way. Ultimately, Baby Max arrived on Wednesday, April 28th, just before noon.
He peed on the entire OR team on the way out. That’s my boy.
Since the delivery method was a C-section, the new plan was to stay in the hospital until Saturday, May 1st. These few days in the hospital would give Mrs. Max OOP some time to recover from major abdominal surgery and the labor and delivery team time to monitor little Max.
I took advantage of our time in the birthing center post-delivery. I went out of my way to own up to my limited knowledge of basic infant care. Max didn’t even know how to hold a newborn properly.
The nurses were fantastic and showed me everything from how to change a diaper to how to swaddle a baby. My swaddle technique is now flawless. Additionally, many of the nurses were certified lactation consultants and gave Mrs. Max OOP plenty of tips on breastfeeding. They would deliver coffee, hot packs, and virtually anything we asked for to the room. I could dedicate an entire post to just how wonderful these nurses were.
The food was great too. We enjoyed every meal, from pancakes, eggs, and chocolate milk for breakfast to a steak and pork chops candlelight dinner. The nurses would even take little Max to the nursery at night for a few hours to give us some time to sleep.
It seemed like things were smooth sailing. Then Saturday came.
A Worrisome Eye Infection
We noticed shortly after delivery that little Max’s left eye seemed somewhat irritated. The nurses and pediatrician seemed to think it was something call conjunctivitis. Nothing like a little conjunctivitis to toughen a kid up. To a finance guy like Max, it did not look like much. I just assumed it was related to the birthing process and would heal on its own. But as the days went on, it didn’t seem to be getting better.
Apparently these were more than just angel kisses.
Two separate pediatricians looked at his eye during our first few days in the hospital. It was evaluated on Wednesday, Thursday, and Friday and the message was consistent: conjunctivitis or a blocked tear duct. They did a culture of the eye to be safe, but those results would take a few days. They also put something called erythromycin in his eyes, which is pretty much the standard of care for all babies.
Then, on Saturday, as we were all set to discharge to our new life of diapers and swaddle competitions, a third doctor had a different take. They thought the eye discharge had a green look to it, which signaled a possible infection. They quickly snapped some photos and used our modern-day telehealth technology to send them off to a specialist in a faraway city for a second opinion.
Little did we know this action sealed our fate.
An Unexpected Ambulance Transport
The Max Out of Pocket crew quickly found ourselves in the scary realm of illness and injury. That’s a terrifying place to be with a newborn.
I have come to understand that babies are not supposed to get infections. Since their immune system has not developed much yet, an infection such as this is worrisome. I stole the term ‘worrisome’ directly from the *quirky infectious disease expert we worked with. Although she didn’t have a cane or a Vicodin addiction, she clearly knew her stuff. Not only did the clinical team need to understand the source of the infection (virus vs. bacteria), but they also needed to make sure it had not spread to other parts of his body.
To test for this, they would need to do a lumbar puncture on little Max and gather some spinal fluid. They would then systematically infuse the little man with antibiotics to take out whatever was causing the infection. We were not crazy about either of these solutions.
Since the local hospital we were so happy with did not have a specialist to offer this type of service, little Max would need to be transported 62 miles by ambulance to a special hospital that could handle this type of thing. They had a whole team on “standby” to come to our hospital and pick him up. They just needed our consent.
At the time, for adult Max, this all seemed a little much. The little man seemed completely healthy to me. But finance people count beans for a reason, so we left it up to the experts and gave them the okay for transport and to move forward with the lumbar puncture.
Baby Max Lands in the NICU?
Baby Max went on ahead of us to the big city hospital. He landed in the neonatal intensive care unit (NICU). As a first-time parent, I had a hard time accepting this. How did we go from being discharged home to the NICU unit?
Since we were a few hours behind due to complications from Mrs. Max OOP’s spinal headache, they offered us donor milk to keep him fed. This is a fantastic program that I will not touch on in this post, but we approved them to use donor milk in lieu of formula.
They also needed to move forward with the lumbar puncture and requested our consent over the phone before we got there. We gave it.
The clinical team had basically completed everything by the time we got to the big city hospital. The lumbar puncture was complete, lab work was processing, and antibiotics were flowing. It was now a waiting game. We would need to wait about 48 hours for the cultures to grow to rule out the more concerning possibilities. They put Little Max on contact precautions, and the clinical team would gown up before each visit.
On day two, they were able to transfer us out of the NICU to a more appropriate pediatric hospital. This move was nice because we could now all be in the same room. Little Max remained on contact precautions throughout our stay in the hospital. At this point, his eye was looking better by the hour.
After about 48 hours, they could rule out some of the really ‘worrisome’ viruses and bacteria. They even discontinued one of the antibiotics during the second night after one of the tests came back negative. After meeting with the infectious disease specialist and the attending physician on the second day, they discharged us. They determined the cause of the infection was likely a bacteria regularly found on our skin. Evidently, the antibiotics nipped it.
We headed home for some peace and normalcy. Our two-minute drive home would now be an hour and a half. That’s a long drive when you are still recovering from a spinal headache and can’t lay flat. Max didn’t get lost on the way home.
As it turns out, my $22,450 health insurance plan will come in handy this year. I used to poke fun at this number; maybe I need to think through that some more. This is why we have insurance, and why we paid into the system for so many years. Insurance is risk-adjusted, and this event is built into the risk equation.
As for out-of-pocket costs? As you all know, it is easy for me to get stuck in the weeds here. But at the end of the day, itemizing these services out doesn’t make sense for us. Any way you cut it, this baby delivery is going to cost us $6,600, which is our 2021 out-of-pocket maximum. The insurance company should pick up the rest. This $6,600 will include antepartum care, ultrasounds, the delivery, prescriptions, and postpartum care for both little Max and Mrs. Max OOP. And it’s really not something we need to worry about. After years of planning, we have over $60,000 in our health savings account. This will be just a drop in the bucket.
After a few extra days, we still got to bring our little swaddled bundle of happiness home. That is all that matters. I can now kick off my parental leave and bond with baby Max.
I am still thinking through what happened. Initially, I thought this was way too much of an aggressive approach in treating little Max’s eye. I could probably find a media outlet that would go as far as to accuse the doctors of ‘running up the bill.’
But I don’t see it that way.
The bottom line is this. Our baby was less than three days old, and he had an unexplained infection that was not getting better. These things can move fast. We left it to the experts to do what was right. The situation also wasn’t unheard of. One of the nurses in the NICU said she saw this type of thing three times in the last month.
In the end, I continue to be amazed at the healthcare resources this country has just waiting on “standby” for us to need them. I will say this, though – the further we got away from our small community hospital, the more I felt like we were being pulled into a “system”. Even for me, it was difficult to keep up with and connect one specialist with another or understand who was the ultimate decision-maker. That just wasn’t the case at our local hospital.
I am fine spending a heavily tax-subsidized $6,600 on the delivery and proactive treatment of little Max’s eye. I probably drank a few hundred dollars worth of hospital coffee. They even put us up in a family room for a night right outside the NICU.
But I have to say, I am on the edge of my seat wondering how much that 62-mile infant transport will cost. Any wagers? I am thinking $5,000 or more. Hopefully, the insurance doesn’t try to deny it. They would be picking a fight with the wrong person.
*Quirky is not a negative, I like quirky people.