PE-owned physician group backed Florida C-section policy shift

A debated Florida law that allows physicians to perform cesarean deliveries outside of hospitals came about after backing by a private equity-owned physicians group, according to KFF Health News.

Women's Care Enterprises lobbied the Florida Legislature in support of the law and said the change will reduce costs and give pregnant women a homier birthing experience, the outlet reported.

"We have patients who don't want to deliver in a hospital, and that breaks our heart," said Stephen Snow, MD, who recently retired as an OB-GYN with Women's Care and testified before the lawmakers in 2018, according to KFF Health News.

Brittany Miller, vice president of strategic initiatives with Women's Care, told the outlet the group would not comment on the issue.

Women's Care Enterprises operates primarily in Florida with additional operations in California and Kentucky, and employs more than 250 equity and employed physicians and more than 130 midwives and other medical professionals, according to the group's website. International investment firm BC Partners acquired Women's Care Enterprises in December 2020.

The change the group supports is part of a legislative package, Live Healthy, signed by Florida Gov. Ron DeSantis in March with the intention of growing the state's healthcare workforce, expanding care access and promoting innovation in the industry. Under the legislation, standalone birth centers designated as an "advanced birth center" will be allowed to perform "planned low-risk cesarean deliveries."

The measure remains an area of debate. Lawmakers who support Live Healthy suggested the change is meant to boost access and address maternity care deserts in the state. Seventeen Florida hospitals have closed their maternity units since 2019, according to KFF Health News, which cites information from the Florida Hospital Association.

However, the American College of Obstetricians and Gynecologists contends that the change will increase risks for women and babies when there are complications, according to KFF Health News.

"A pregnant patient that is considered low risk in one moment can suddenly need lifesaving care in the next," Cole Greves, MD, an Orlando perinatologist who chairs the Florida chapter of the ACOG, told the outlet via email. The new birth clinics, "even with increased regulation, cannot guarantee the level of safety patients would receive within a hospital."

The Florida Hospital Association shared the following statement with Becker's in April: "FHA was opposed to the establishment of advanced birthing centers due to a deep concern about the safety and welfare of moms and babies. We do not believe it is safe to perform C-sections at these freestanding centers." 

Although the Florida Hospital Association expressed these and other concerns, it did not fight passage of the change because the legislation also included a bump in Medicaid reimbursement for maternity care, according to KFF Health News.

Read the full KFF Health News report here.

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