Crumbling rural healthcare system affecting expecting mothers

Crumbling rural healthcare system affecting expecting mothers

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LUBBOCK, Texas -

It is a problem with colossal implications. 

Access to healthcare in rural America is dwindling. Texas providers, if they have not already closed their doors, are reducing the number of options being provided due to an increased financial strain.

It is a problem hospital administrators across West Texas are trying to deal with. Of the 163 rural hospitals in Texas, only 70 still have labor and delivery units. Around the South Plains there are only a handful that still offer these delivery services.

"What they're doing is just a business decision," said Don McBeath, Director of Gov. Relations with the Texas Organization of Rural and Community Hospitals. "They're going in and looking at their operations and they're saying where am I losing the most money and what often bubbles up is labor and delivery services."

The latest to shut its unit down is The Medical Arts Hospital in Lamesa, TX.

Steve Beck, Senior VP at Covenant Health and rural healthcare expert, said these closures leave a vacuum for expecting mothers and often means they will have to drive long distances for care. 

"For that hospital they're now 40-60 minutes away from the labor and delivery unit," Beck said. "And then you also look at, where's that prenatal care going to come from. If my hospital no longer labor and delivery am I going to have physicians that even provide prenatal care."

This is a problem the Muleshoe Area Medical Center faces. Its labor and delivery unit closed about a decade ago. Mothers will still come in though after they are not able to make the journey to Lubbock.

"If they have their OBGYN in Lubbock and that's where they're going sometimes they will wait too long and, or they think they're going into labor and they come in here," said Dennis Fleenor, Administrator of Muleshoe Area Medical Center.

Muleshoe, like many others, quit delivering babies due to the rising costs. 

"You have to have a full surgical, you have to have to be able to do c-sections at a moments notice which means you also have to have an antsiest on call 24-7," Fleenor said. "The risks far out weigh the benefit."

These closures are likely just cracks in a quickly crumbling system though.

"Rural hospitals all across the state and all across this country are in a growing financial bind," McBeath said.

This bind comes from rural hospitals simply not getting reimbursed by its largest population of patients. 

"The majority of all patients, especially labor and delivery patients are on medicaid or they're uninsured so it becomes a funding challenge that you simply can't get the money it costs to maintain that service," Beck said.

That is killing small towns.

"Our medicare reimbursement is only 98 percent of costs, actual costs in a critical access hospital," Fleenor said. "So you're already two percent upside down."

McBeath said the blame for this lies at the feet of state and federal policy makers.

"That financial bind is created by a series of cuts and payment reductions that were authorized by or allowed to happen by Congress and the Texas legislature," McBeath said.

There is not an easy fix for this problem either. It is a multi-tiered problem that will likely take law makers overhauling the entire system and it should begin with funding. 

McBeath said then, and only then could we start seeing hospital operate in a more comfortable margin and reopen some of the shuttered labor and delivery units.

"You gotta get the payment rates back up on medicaid, which is 70 percent of the deliveries in rural Texas, back up to where it covers the cost and you don't make the hospital take a loss," he said. "If you do that then more of the rural hospitals, I think would consider providing labor and delivery services so then young mothers in rural Texas can deliver that baby and get prenatal care closer to home."

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