Rural Hospitals Struggle to Keep Labor & Delivery Departments Operational
TL/DR –
Rural hospitals across the U.S. are struggling to keep labor and delivery departments open due to staffing shortages, low Medicaid reimbursement payments, and declining birth rates. Since 2020, over 100 hospitals in 26 states have closed these departments, making maternity care inaccessible for many rural women. The high maintenance cost of L&D units and proposed cuts to Medicaid could further exacerbate this issue, despite efforts to promote higher birth rates.
Increasing Struggles for Labor and Delivery Departments in Rural US Hospitals
A report from the Center for Healthcare Quality & Payment Reform reveals that rural hospitals in the United States are battling to sustain their labor and delivery departments, which is making safe birth care inaccessible for many rural women. Since 2020, over 100 such hospitals in 26 states have shut down their L&D units, leaving today less than 1,000 rural hospitals offering the service.
The closures have been attributed to factors such as staffing shortages, inadequate Medicaid reimbursement payments, and declining birth rates. In response, some states have initiated changes in Medicaid fund utilization, led the establishment of freestanding birth centers, or motivated urban-based obstetricians to establish satellite clinics in rural regions. Consequently, this has resulted in women delivering in emergency rooms, inadequate prenatal care, and a surge in preterm births.
L&D units present a financial burden due to their requirement for round-the-clock staffing. Typically, hospitals are not paid by insurers to maintain this readiness capacity but are compensated per birth. These expenses are offset by hospitals through income from more profitable services. However, for rural hospitals with fewer births, these costs can be overwhelming.
Despite attempts by the Trump administration to boost birth rates, potential cuts to Medicaid could aggravate the situation.
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