A new report has found that the majority of Florida rural hospitals do not provide labor and delivery services.
The Center for Healthcare Quality and Payment Reform analyzed federal data and found that, as of January, 18 of the state’s rural hospitals no longer have obstetrics care. The report also reports that at least one of the three hospitals still providing care was losing money from it.
Many hospitals are shuttering their units because insurance companies and Medicaid aren't reimbursing hospitals enough to cover the cost of births, the report notes.
“Rural hospitals can’t provide labor and delivery services if they are unable to find an adequate number of qualified staff, but they can’t afford to employ adequate staff unless they receive adequate health insurance payments for delivering babies,” says the Pittsburgh-based center, which works to facilitate improvements in health care payment and delivery.
“Maintaining access to high-quality maternity care in rural areas requires addressing both the workforce recruitment and payment challenges facing rural hospitals.”
The data show that it's likely more hospitals will shutter units as they continue to face financial struggles.
Another concern is the distance rural patients must travel to hospitals providing such care. The report estimated the median time pregnant Floridians who don't have local care would have to drive to an alternative unit is 50 minutes.
In most urban areas, the travel time to a hospital with labor and delivery services is under 20 minutes, but in rural areas, it is likely to be at least 30 minutes and often 40 minutes or more, the report notes.
Harold Miller, the center’s CEO and president, says that driving further for care has an effect past the birth date. It may also mean the facility does not have adequate prenatal and postpartum care.
The report comes as Florida lawmakers have pushed a plan to grow the state’s health care workforce, increase care access and incentivize innovation. A $717 million legislation package titled the “Live Healthy Act” has been passed by the Legislature only needs the governor’s signature.
The package includes provisions that would reduce regulations for autonomous nurse midwives, expand telehealth maternity care and create a designation for advanced birth centers.
The birth centers would have staff members who would be able to stabilize a mother and baby in the case of an emergency until they can be transported to the nearest hospital. Right now, birth centers are limited to providing care for low-risk pregnancies with expected vaginal births.
The advanced designation would expand the kind of care the centers could offer and allow patients who require cesarean sections to stay overnight for continued care. Similar efforts in the past have hit roadblocks because of concerns about safety — especially in rural areas.
Information from WFSU and Iowa Public Radio was used in this report.
