Recently adopted law in Florida, which allows doctors to deliver children through the imperial section in clinics outside hospitals, can be a plan for other states, even when critics indicate the role played by a group of doctors supported by Private Equity in their fragment.
The United States has impoverished mother’s health results compared to peer nations, and the labor force units and hospital delivery will cast throughout the country due to financial burden. Supporters say that the law in Florida can enhance access to maternity care and reduce the costs of the expected patients.
But critics, including some groups of doctors, hospital and midwife, warn that this is an unexpected model that can expose the health of mothers and children. They also notice that private equity companies that have made other cases in healthcare attracted state control for allegedly appreciating profits for patient safety.
Alex Borsa, a researcher from Columbia University, whose published works focus on the influence of private equity on healthcare, said that he is not surprised that Florida became the basis of such clinics.
“In addition to the fact that Florida is a wild West in many directions of politics, it has one of the highest concentrations of healthcare operators supported by private equity, including ob-gyn and fertility,” said Borsa.
Traditional birth centers are usually planted by midwives, which provide maternal care in pregnancy and low -risk births. Twenty -nine such centers operate in Florida, and about 400 are licensed throughout the country. In these centers, he focused on natural delivery in home scenery, in which women work without anesthesia and provide children.
Florida’s law creates a fresh designation, called the “advanced birth center”, which allows doctors to offer work and delivery services in a free -standing clinic, including delivery according to the imperial section. There are currently no such centers. Section C is a surgical procedure carried out with anesthesia, in which the child is supplied by an incision into the patient’s stomach and uterus. Sections C are generally reserved in situations where the doctor believes that vaginal childbirth may be risky for a mother or child.
Before undergoing the right of last spring, C-sections C could only be performed in hospitals that have staff and equipment designed for surgery and potential complications.
But the medical group belonging to women in recent years in recent years has lobbyed legislators in Florida for the fresh designation. The group, belonging to the London investment company BC Partners, runs about 100 clinics in Florida and a dozen or so more in Arizona, California and Kentucky.
The fresh designation has been hidden in a greater health policy Bill And he became the law despite the opposition of medical groups and midwives.
“Both mother and child deserve access to the best possible care, which is why we think that sections C should only be performed in a hospital where doctors, multidisciplinary teams, sophisticated equipment and other critical resources are immediately available in the event complications”, ” Stateline said the president and general director of Florida Hospital Association in a statement.
But the association did not fight the bill, which, among other things, increased Medicaid payments to hospitals for maternity care. Other groups objected to this.
“We are above all against because you call the lion tiger,” said Kate Bauer, executive director of the American Association of Birth Center, Non -Profit, which establishes national standards of birth centers.
She noticed that although advanced birth centers would offer maternal care outside the hospital place, they are not the same as customary birth centers based on obstetrician. The birth of midwives is intended for people with low risk pregnancies and usually focus on low intervention care and emphasize natural delivery techniques. Births used doctors tend to rely on more advanced medical interventions, such as epidurale and drug -induced drugs.
Private equity jumps
Legislators in Florida supporting the fresh advanced designation of birth centers said that it can enhance access to matrix care in underestimated areas and reduce costs. Just two They have work and delivery services from 22 rural hospitals in Florida.
Employees of Senator State Florida Gayle Harrell, a Republican who sponsored the law, told Stateline that it is not possible to comment on it. But during previous interrogations of the Committee, republican legislators heralded centers as an novel solution of obstetric care.
“I think that what we hear from our medical community is a desire for the option,” said State Senator Colleen Burton, a republican, in December 2023, December 2023 Committee hearing on the account. “And we especially hear that patients, from Floridian, [who want] Options. And this can potentially be the option of lower costs. “
But critics ask if Ob-Gyns, already briefly equipped in Florida, will probably open advanced delivery centers in low-income and rural communities, in which Medicaid has a greater participation of patients. Insurance sponsored by the government returns doctors much less for maternal care compared to private insurance.
BORSA from Columbia University, co-author of study 2020, in which it was found that the Ob-Gyn offices belonging to Private Equity were more likely that they will be in urban areas with the median of household income above the national average.
Private Equity uses from investors collective money to buy control rates in companies. They usually focus on increasing the company’s value before selling it within a few years, preferably with a profit. Over the past decade, private equity investors have spent $ 1 trillion by purchasing healthcare companies.
Borsa said he and his colleagues had I found robust evidence that private equity involvement in healthcare “quite consistently increases the costs of patients and payers.”
“There is a fantasy that investors from Wall Street will somehow increase access in the most rural and poor parts of the country, but we did not see it evidence,” he said.
In recent years, private equity in the healthcare industry has attracted public anger and legislative control. For example, this month, the US Senate Budget Committee has published report In detail in how Private Equity included hundreds of millions of fighting hospitals.
Dr. Helen Kuroki, medical director for women’s care enterprises, refused to comment on the support of the fresh law and when he can open an advanced birth center. Representatives have He said earlier They look at the opening of the center in Tampa or Orlando.
Working force and delivery services are usually losers finances for hospitals, thanks to low return rates, especially with Medicaid. In rural areas where Medicaid covers the same half Of all births, the reimbursement of costs does not include the full cost of providing obstetric services.
If patients covered by better paid private insurance, they will go to free -standing delivery centers that can be performed by sections C, would leave hospitals with a higher percentage of Medicaid patients. Having a surgical space would allow doctors such as Women’s Care Enterprises to stop more returnable dollars that would normally go to the hospital.
Like surgical centers – something like
Supporters compared the fresh model of the Florida Birth Center to outpatient surgery centers, in which patients undergo surgical procedures that do not require a hospital night stay. Patients who undergo sections C would be able to stay in fresh birth centers overnight.
But critics say that Section C is different from nature from, say, cataract surgery or tonsil cut -out.
“We have seen that outpatient surgery centers can be a successful healthcare model,” said Bauer from the Center Birth Association. “For me, the main difference is that surgical delivery is the only operation in which you have an additional person after finishing. And he is an additional person whose health can be threatened. “
Some legislators from Florida expressed concern that fresh centers would not have to have pediatric specialists at hand to look after the child if the problem after birth occurs. Centers are obliged to a written contract with a local hospital to transfer patients with complications. They must also follow most safety standards for outpatient surgical centers.
So far, Florida remains more protruding. Legislators in other states have not yet introduced similar bills.
But when private equity deepens their involvement in women’s health and other sectors of healthcare, Bors expects that they will enhance the lobbying of state legislators to win favorable changes in politics.
“We saw more healthcare lobbyers, specifically around this problem in other parts of the country,” he said. “I don’t think this is one -off, especially if they think they can profit.”
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