Every year, employers spend billions on pregnancy and neonatal complications—the catch: These issues are often preventable. Preterm births alone account for an estimated $6 to $14 billion annually in added medical costs absorbed by employer-sponsored health plans. Lifetime costs per preterm birth average $64,800, and for those born extremely preterm, NICU costs can even exceed $344,000. Beyond the financial impact, these complications disrupt families, contribute to employee stress and exacerbate losses in productivity and attendance.
While most companies have already made their selections for 2026, it is never too early to begin planning for the next open enrollment season. For HR leaders tasked with designing benefit strategies that balance cost containment, talent acquisition, long-term retention and equity, maternity and NICU care management presents a rare win-win: supporting employees and their families through stressful times, while directly reducing their own financial and operational risk.
See also: Employees should have access to paid parental leave—no matter where they live
An overlooked opportunity
Every year, employers rank pregnancy and childbirth among the most common and costly conditions to cover; yet, they approach maternal care as a “standard” benefit, part of a broader medical coverage plan. Without additional support, organizations miss the outsized opportunity for improvement: both to help minimize the costs and support talent through this life-changing milestone.
These benefits have shown an outsized impact for both employees and their employers. Those with access to specialty care management programs focused on maternal and infant health see more positive outcomes than those without, particularly when it comes to preterm birth rates.
Even from an economic perspective, the benefits are clear: Each preterm or low-birth-weight birth represents nearly $15,000 in avoidable medical costs; scaled across even a mid-sized workforce, the savings are considerable. A recent analysis found that benefits that help support prenatal care and healthy pregnancies, and which result in cutting preterm birth rates in half, could save more than $28 billion each year.
Why are costs rising?
Several trends are contributing to rising NICU costs, all of which make maternity support more urgent than ever before. More and more individuals are electing to start families later in life, and the risk of complications increases after age 35. Meanwhile, some fertility benefits, when not paired with comprehensive case management, can contribute to higher-order multiple pregnancies, raising the risk of premature birth. Lastly, at a macro level, a less healthy U.S. population means more pregnancies begin with underlying chronic conditions such as hypertension or diabetes. Together, these factors raise the cost curve, unless employers actively intervene with benefits that help prevent complications and guide families through high-risk pregnancies.
In another review, 30% of NICU claims were incorrectly billed at higher rates. Specialty NICU payment integrity programs help identify inconsistencies between authorized services, billing codes and documented treatments, which allow health plans and self-ensured employers to optimize recovered savings—while ensuring employees are always receiving the most appropriate and highest-quality care.
The value ripples far beyond cost containment to impact job satisfaction and workforce management at scale. By supporting healthier pregnancies and helping avoid unnecessary complications, new families experience better starts. And as a result, returning to work feels less daunting: Employees take less leave, experience less stress and are more likely to remain engaged at work.
How leading employers are standing out
Forward-looking organizations are starting to treat maternal and infant health benefits as a lever for cost control, equity and retention. Several strategies are emerging:
- Dedicated care management programs. Vendors that specialize in maternal and NICU care management help ensure families receive guidance through high-risk pregnancies, neonatal transitions and postpartum recovery. Through dedicated support, these programs have been shown to reduce complications and shorten NICU stays, supporting both cost containment and employee wellbeing initiatives.
- Integrated prenatal models. Programs like group prenatal care not only deliver better outcomes but also foster social support, which has been linked to lower preterm birth rates.
- Proactive risk-identification solutions. Predictive analytics are helping care teams identify at-risk pregnancies earlier, enabling proactive outreach and coordination that help launch interventions, even before costly complications arise.
- Whole-family support. Employers are recognizing that employee wellbeing is inherently connected to their overall family wellbeing, and are offering family-first benefits, such as lactation services, mental health counseling and even structured return-to-work programs.
While these were once seen as experimental or “nice-to-have” offerings, employers are increasingly recognizing the role that family health plays on their employees’ wellbeing, attendance and job satisfaction, which all bear a marked and direct impact on their business’ financial health.
A new benefits season
As the open enrollment period comes and goes, a new opportunity to consider family benefits lies just around the corner. Employers have a very real opportunity to seize the moment and make a real change, leading with new benefits that invest in employees and their families.
With an array of proven family benefits that support individuals and businesses alike, maternal care no longer needs to remain a cost driver or silent contributor to workforce turnover. This year, consider family benefits as a strategic investment, one that lowers claims, strengthens retention and advances equity goals.
To realize this untapped value, HR leaders can begin by:
- Reframing maternal support: Instead of viewing maternity programs as a compliance checkbox, recognize them as a core cost and talent strategy with long-term dividends.
- Measuring outcomes: Family benefits are designed to support both individuals and the organizations they work for. Track their ROI by monitoring reductions in complications, shorter NICU stays, reduced ER visits or hospital readmissions, and retention among working parents.
- Choosing strategic partners: With a bevy of options available, make sure to evaluate vendors closely, asking for demonstrable results, ability to integrate with existing benefits and the ways they support equity across employee populations.
Ultimately, when employees and their families thrive, so do their employers. By offering a package that includes maternity benefits, you’re not only identifying untapped cost savings, but you’re supporting your organization from the inside out, investing in healthier employees motivated to stick with you for the long term.
