Louisiana might be better. Disastrous consequences for pregnant women If the state increases Medicaid reimbursement rates for maternity care and increases the number of midwives, A leading expert on maternal mortality said Wednesday.
Dr. Veronica Gillispie-Bell is a New Orleans gynecologist and co-director of the Louisiana Perinatal Quality Collaborative. with the state health department She is also the 2022 State Writer. Louisiana pregnancy-related death review report..
Louisiana had the fifth-highest maternal death rate of any state in the country from 2018 to 2021, with 39 expectant parent deaths per 100,000 live births, according to KFF. which is a health policy research organization The only states with higher rates are Arkansas, Mississippi, Tennessee and Alabama.
Gillispie-Bell It said the state’s pregnancy outcomes could be better if Louisiana paid hospitals and medical providers more to deliver births. The state’s current Medicaid reimbursement rates are too low to be an incentive for medical providers to continue providing those services, she said.
Medicaid, which is your state’s insurance provider It pays about 60% of births that occur in Louisiana. But the reimbursement rate is half the amount offered by private insurance companies. Louisiana’s Medicaid program provides $5,131 to health care providers for maternity care. Meanwhile, private insurance will pay an average of $11,990 for the same service. Gillispie-Bell said.
It is very difficult for them to leave the door open when they are not being paid to do so. Gillispie-Bell Addressed medical providers during the Maternal Death and Prematurity Nursing Conference on Wednesday.
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Many hospitals lose money on obstetrics services, she said. They mostly offer maternity services to lure parents and families back for other medical care. It can be difficult for small facilities in rural areas to compensate for those expenses she added
When they can’t break even [on live births]I think that [rural medical providers] Making a hard decision Gillispie-Bell said.
Finding pregnancy health care in rural areas is already difficult. Gillispie-Bell said 27% of Louisiana’s counties have no medical care for pregnant women, and 12% of women do not have a hospital that provides maternity care within 30 minutes of where they live.
The Louisiana Legislature and Gov. Jeff Landry’s nominees will have the authority to increase Medicaid reimbursement rates next year, even though the increased payments will increase the state’s health care budget. up as well
Both state and federal tax dollars cover the cost of the Medicaid program, and conservative lawmakers have sometimes been reluctant to increase spending on public health services.
In the state after Louisiana Mothers will soon be able to recoup half of pregnancy expenses from fathers.
Gillispie-Bell also believes Louisiana should do it. Expand the use of midwives in childbirth.Especially with a national shortage of obstetricians by 2030, Louisiana has one of the lowest rates of midwife utilization in the country. And the model should be considered in other rural states, such as Alaska, where midwives routinely oversee births.
Some of the challenges Louisiana faces in addressing its high maternal mortality rate also relate to other social and chronic health challenges. Of Louisiana’s childbearing residents, 35% live in homes that had an income of $16,000 or less, 64% were overweight or obese, and 53% did not intend to become pregnant. Gillispie-Bell said during her presentation.
From 2017 to 2019, there were 182 confirmed deaths during pregnancy or within one year of ending a pregnancy.
The leading causes of these deaths include accidental drug overdoses (31), homicide (24), car crashes (23) and cardiovascular conditions (20), according to the data. Latest state maternal death report. Nine of the deaths may also have been due to suicide.
Nearly half of those who gave birth in Louisiana during that time had only a general equivalency diploma (GED) or less, but 68% of those who died during pregnancy or in later years It’s appropriate for that demographic.
Racial discrimination also plays a role in the state’s maternal mortality rate. Over the past two years, 33% of births identified as Black, Gillispie-Bell said. But black people account for 57% of individuals who die during pregnancy or in the year after their pregnancy ends.
We have to address minimum wages, violence, access to care … and access to education to help improve outcomes for pregnant people, she said.
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