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Barry R. FreedmanPresident and CEO Einstein Healthcare Network
On Sunday we will happily indulge our mothers with cards, flowers and breakfasts in bed, while hospital officials such as myself puzzle over the disparity between our personal deference – and government indifference – toward motherhood. Consider this: the proposed Pennsylvania state budget would slash funds paid to hospitals for the delivery of babies.
Einstein Healthcare Network is one of only six medical centers in Philadelphia that still delivers babies. Over the past 15 years, 18 local hospitals closed their obstetrics departments primarily because of the financial burden of rising malpractice costs combined with inadequate reimbursements.
To make matters worse, the state proposes to change the Medicaid formula used to pay hospitals for births, and slash a special fund to compensate hospitals that have kept their obstetrics departments open for their increased patient load. The state’s proposal, if passed, could further limit options to pregnant women who’ve already experienced greatly diminished access to care.
Einstein has refused to shut down our obstetrics department, despite pressing financial burdens. We’re a teaching hospital and Ob/Gyn is an essential part of medical education. More importantly, closing the door to the delivery room is unthinkable, given our mission to provide the full range of health care services to our community. What is a more basic healthcare service than the delivery of a newborn?
Instead, we made improvements to respond to the increased demand for our delivery facilities. We renovated our obstetrics space to enhance flow and utilization; we created a triage unit which functions as an emergency room for pregnant women; we hired nurse practitioners to help us manage the flow. Thanks to the initiative of Dr. Arnold Cohen, chair of Ob/Gyn, we instituted an electronic medical records system that reduces the incidence of complications during delivery and improves clinical outcomes. Dr. Cohen also meets regularly with his counterparts at the city’s five other hospitals which deliver babies, in a collaborative effort to develop clinical protocols that insure quality and consistency of care in the city.
Einstein now delivers 3,100 babies a year – 50 percent more than we did eight years ago. And we’ll do even more when our new hospital, Einstein Medical Center Montgomery, opens in East Norriton in September.
While we accomplish more with less, the state proposes to make even more cuts. Three years ago, the state invested nearly $7 million in a support program for obstetrics and neonatal services across Pennsylvania – which was matched by the federal government to create nearly $15 million in funding. This year’s state budget contains only $3.3 million for the program – a cut of more than 50 percent in the past three years. Not to mention that the Department of Public Welfare proposes to change the formula for reimbursing hospitals: instead of making two payments, one for mother and one for child, they propose to eliminate the reimbursement for the care of newborns and only cover healthcare services for mothers.
It seems unconscionable to me. Not only has women’s health been in the crosshairs of recent national political debate, it seems to be first up on the chopping block in Pennsylvania when money is tight.
What’s next? A surcharge on apple pie? Of course we wouldn’t stand for that. Nor should we allow government policy to undermine the very institution we celebrate today.