Medicaid expansion had little effect on obstetric service closures, study finds

Although Medicaid expansion decreased hospital closures, it has had little effect on obstetric service closures, an April Health Affairs study found.

The researchers used data from American Hospital Association surveys and information on obstetric service provision from CMS to track obstetric service closures from 2010 and 2017.

Rural obstetric units were less likely to close immediately after Medicaid expansion, but this effect tapered off within two years, according to the study.

The decrease in overall hospital closures was mostly found in hospitals that did not have obstetric units.

Obstetric services have decreased in the last decade because they are often unprofitable, according to the study. Medicaid expansion has been introduced as a possible solution because it diminishes uncompensated care and improves hospital finances.

"Policies aiming to address obstetric closure may need to tailor solutions to the challenges facing this particular service line — for example, low Medicaid reimbursement rates," the study suggested.

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