Our Summary

This study looks at the costs of cleft lip and palate surgeries in the U.S, from 2007 to 2016. It found that both the amount paid by health insurance companies to hospitals and doctors (provider payments), and the amount paid by patients and their families (beneficiary contribution), have increased significantly. The patient’s cost share was found to be higher due to an increase in deductibles (the amount you pay for healthcare services before your health insurance begins to pay). This trend of higher cost-sharing was more noticeable in the South. This means that patients are having to pay more for these surgeries while insurance companies are also paying more to the providers. Further research is needed to understand how these increased costs are affecting parents’ decisions to have these surgeries for their children.

FAQs

  1. How have the costs of cleft lip and palate surgeries changed in the U.S. between 2007 and 2016?
  2. Why have the costs paid by patients and their families for cleft lip and palate surgeries increased?
  3. Has the increase in cost-sharing for cleft lip and palate surgeries been more noticeable in certain regions of the U.S.?

Doctor’s Tip

One helpful tip a doctor might give a patient about cleft lip repair is to make sure to discuss all potential costs and financial considerations with your healthcare provider and insurance company before the surgery. This can help you be prepared for any out-of-pocket expenses and ensure that you have a clear understanding of your financial responsibilities. Additionally, exploring all available resources for financial assistance, such as payment plans, assistance programs, or grants, can help alleviate some of the financial burden associated with cleft lip repair surgery.

Suitable For

Patients who are typically recommended cleft lip repair surgery include:

  • Infants born with a cleft lip
  • Children with a cleft lip who are experiencing difficulties with feeding, speech development, or social interactions
  • Adults with a cleft lip who are seeking cosmetic improvement or functional improvements
  • Patients with a cleft lip who are experiencing psychological distress or low self-esteem due to their appearance

It is important for patients to consult with a team of medical professionals, including a plastic surgeon, orthodontist, speech therapist, and psychologist, to determine the best course of treatment for their individual needs.

Timeline

Before cleft lip repair:

  • Patient is born with cleft lip
  • Patient may experience difficulties with feeding, speech, and social interactions
  • Patient and family may undergo counseling and education about the condition
  • Patient may undergo pre-operative evaluations and tests

After cleft lip repair:

  • Patient undergoes surgery to repair the cleft lip
  • Patient may experience swelling, bruising, and discomfort post-surgery
  • Patient may require pain medication and follow-up care
  • Patient may undergo speech therapy and other interventions to address any remaining issues
  • Patient and family may experience emotional and financial challenges related to the surgery and recovery

What to Ask Your Doctor

  1. What are the risks and potential complications associated with cleft lip repair surgery?
  2. How long is the recovery process and what can I expect during this time?
  3. Will there be any scarring after the surgery and what can be done to minimize it?
  4. Will my child require additional surgeries or treatments in the future?
  5. What type of anesthesia will be used during the surgery and what are the potential side effects?
  6. How experienced is the surgical team in performing cleft lip repair surgeries?
  7. What type of follow-up care will be needed after the surgery?
  8. Are there any alternative treatment options available for cleft lip repair?
  9. How much will the surgery cost and what is covered by my insurance?
  10. Are there any support groups or resources available for parents of children with cleft lip?

Reference

Authors: Rochlin DH, Ma LW, Sheckter CC, Lorenz HP. Journal: Ann Plast Surg. 2022 May 1;88(4 Suppl 4):S343-S347. doi: 10.1097/SAP.0000000000003081. Epub 2022 Feb 21. PMID: 35180754