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PURPOSE OF HB 1103
To create the Universal Newborn Home Nurse Visitation Program to provide home visitation
services for a newborn infant and the parents of a newborn infant.
ACTUARIAL STATEMENT
The Fiscal Impact Statement was prepared according to generally accepted actuarial principles and
practices, in compliance with ACT 112. The Statement provides an estimate of the financial and
actuarial effect of the proposed change(s) on the Plans, if possible. The Statement makes no
comment or opinion with regard to the merits of the measure for which the Statement is prepared;
however, any identified technical or mechanical defects have been noted.
We have reviewed the input and results of our analysis for reasonableness and relied upon the data
and information provided by the Plans and their Claims Processing Contractors.
3/13/2023
_________________________________________ _________________
Patrick Klein, FSA, MAAA Date
Vice President
3/13/2023
_________________________________________ __________________
Matthew Kersting, FSA, MAAA Date
Vice President
 PROJECTED COSTS
Estimated Cost as a Percent of
Annual Estimated Cost
Plan Total Annual Medical Spend
EBD No Impact - $931,000 0.0% - 0.2%
UOA No Impact - $301,000 0.0% - 0.3%
ASU No Impact - $22,000 0.0% - 0.1%
UCA No Impact - $13,000 0.0% - 0.1%
AHEC No Impact - $4,000 0.0% - 0.2%
NWACC No Impact - $3,000 0.0% - 0.1%
SAU No Impact - $5,000 0.0% - 0.1%
PRICING APPROACH AND COMMENTS
House Bill 1103 requires self-insured health plans to provide newborn home nurse visitation
benefits, including 1 visit within 30 days after birth, an additional 2 visits during the infants first 3
months of life, and additional support services to the parent of the newborn infant.
Cost and utilization metrics were sourced from the administrators of the university system health
plans, Blue Cross and Blue Shield of Arkansas, and publicly available data. The magnitude of
the fiscal impact for each plan was estimated based on a set of developed cost and utilization
assumptions.
This program may have no impact on the plans, which is the low end of the range. There is
uncertainty around how this will benefit will be communicated and how many counties it will be
implemented in. For newborns, many of these services are already covered at 100% as
preventive care provided at a pediatrician’s office. Also, women may forgo the program because
they are more comfortable attending a postpartum visit with their OBGYN. Finally, there is the
potential for savings resulting from avoiding postpartum complications that could offset any direct
costs.
To illustrate the high end estimate, which would represent the maximum level of utilization of the
program, we assumed an average cost of $200 per home nurse visitation based on data supplied
by BCBS. The utilization assumption was derived from the historical average number of births
for each respective plan. Lastly, we assumed program participants would utilize all 3 of the home
nurse visits available. Ultimately, we would anticipate the impact to be closer to the low estimate
(i.e., no impact).
Actual legislative cost impacts to health plans may vary as actual future experience differs from
the assumptions made in developing these cost estimates. Potential for actual experience to vary
from the assumptions made in these estimates includes underlying changes to the cost of home
nurse visitation services and changes in the incidence of childbirth for each plan.