A majority of rural hospitals in Texas are opting to discontinue delivery services as the number of births fall and the cost of providing the service rises, reports the Texas Tribune.
The Texas Organization of Rural and Community Hospitals reports just 69 of Texas' 163 rural hospitals ,or 42 percent, still deliver babies, according to the Texas Tribune.
Don McBeath, director of government relations for the TORCH, said that rural hospitals in the state have been implementing cost-cutting initiatives, including terminating obstetric services, in the past few years due to uncertainty over the federal Disproportionate Share Hospital fund and Texas' Medicaid 1115 waiver, two major funding sources.
Hospitals serving a large portion of low-income patients are eligible to receive DSH payments; however, in October 2017, the federal government cut the fund by 14 percent. Additionally, the 1115 Medicaid waiver program, which reimburses safety-net hospitals offering charity care, has an uncertain future. The program was scheduled to be phased out in 2016; however, Texas received an extension and is currently working to receive another extension.
In the past few years, rural hospitals in Texas have struggled to stay open as uncertainty over federal funding rises and Medicaid reimbursement and physician retention declines. Fourteen rural hospitals in the state have closed since 2013.
As rural hospitals grapple with finances and a loss of federal funding, the low number of births in rural areas has made it difficult to justify the costs of obstetric services.
"If the hospital has to cut services because the funding went away, then [obstetrics] would be most likely the first to go," Mr. McBeath said, according to the Texas Tribune.
The impact of rural hospitals shutting down their delivery departments will be detrimental, according to Mr. McBeath, who says more pregnant women may need to drive long distances to get prenatal care and give birth.
"I do think that this decline in the number of rural hospitals providing [obstetric] services is probably going to increase prenatal and postnatal mortality," he said.