In my state of Pa, 40% of obstetric patients are on Medicaid.
-Medicaid uses a single bundled payment for the entire "global obstetric package," which = 13 antepartum visits, delivery, and 6 weeks of postpartum care.
Don’t forget all the phone calls and messages.
-Reimbursement Amount: from what I found the reimbursement Medicaid pays an obstetrician on average is around $1,100 for that global package including delivery.
-now let’s add malpractice: Pa OB average malpractice rate per year is around $70,000, ( up to 100K in cities) BUT, we are the only state in the nation with an additional malpractice payment called MCARE adding another $20k per year to the cost of malpractice we have runaway verdicts out of Philadelphia. We also have Venu shopping, which means you could be in the western part of the state and dragged into Philly for a case.
Mind you, we haven’t discussed the stress of going through malpractice plus adding potential travel to it.
All of the above is why there are 23out of 67 counties in Pa with no delivery hospital.
Well, this is mostly rural, in my county of books, the hospital where I delivered my two children and worked for 13 years, just closed their OB unit because the obstetricians left. With everything that I’ve written above, who could blame them?
But who suffers most? The patients.
rural.pa.gov/download.cfm?fi…
Cool. Cut all Medicaid CMS reimbursement rates by 50% and repeal the FMAP formula under Section 1905(b) that gives states lower per capita up to 66% more funding. (Of course we would see just about every rural hospital outside of the wealthy states fail in a manner of 6 months)