The way we fund healthcare remains fundamentally broken in Georgia. Â Rural hospitals continue to be our canaries in the coal mine. Â Some hospitals are closing altogether. Â Others, like these two, continue to reduce services offered. Â Georgia Health News reports:
The shuttering of the labor and delivery unit follows similar actions by other hospitals across the state. The obstetrical closures have hit especially hard in rural Georgia, where health care has been imperiled by doctor shortages and shaky hospital finances.
More than 40 Georgia counties lack obstetrical providers, and fewer than 75 of 180 hospitals in the state have labor and delivery units, Pat Cota of the Georgia OB/GYN Society said.
Cota said that when access to obstetrical services is reduced, women have to travel greater distances for prenatal care and deliveries. That increases the chances for a pre-term delivery, she said.
One reason for the obstetrical closures is that itâ€™s difficult to maintain a high-cost service with low reimbursement rates from Medicaid. The government insurance program covers about 60 percent of all Georgia births, and the rate is even higher in rural areas.
Georgia OB/GYNs finally received a Medicaid pay increase â€“ the first in more than a decade â€“ under the recently approved state budget. Yet that wonâ€™t increase the reimbursements to a hospital itself, which deals with the high costs of staffing in its birthing program.
And Georgiaâ€™s rural hospitals, unlike those in some other states, are not getting a revenue boost from Medicaid expansion under the Affordable Care Act. Expansion would extend Medicaid coverage to more low-income patients, meaning the hospitals that treat them would get more revenue. But Georgia is among the states that have rejected Medicaid expansion, saying itâ€™s too costly.