A health-care expert in Illinois questions whether changes to the way doctors report and bill for pregnancy-related services will expand access to maternal care.
The American Medical Association is shifting from a global payment system to itemized billing for prenatal and delivery services. Charles James, president of North American Health Care Management Services, said the update is needed to modernize standards. He said he hoped it would improve access to pregnancy services for families, but added it misses some important points.
"Whether or not that will do that, there are a lot of other very complicated factors in why we have such OB deserts," he said, "and that doesn’t really address those underlying, economic factors that have changed how broadly OB services are available.
Despite some tweaks in 2009, James said billing practices for pregnancy services haven’t been updated since the mid-1990s. The changes will go into effect in January 2027.
Rural hospitals in Illinois continue to struggle to maintain OB departments. More than 100 rural hospitals in Illinois have closed or made plans to close their maternity units since 2020.
James said the effort to address these health-care deserts requires more commitment, as these services cost more to provide in rural communities.
"Until we're serious about offering some pretty dramatic financial incentives in rural areas, especially," she said, "it’s going to require a financial commitment greater than some tweaking of how we're coding and a peripheral issue on these maternal coding changes."
James suggested policy solutions such as waiving bed limitations for critical access hospitals or implementing payment premiums for rural health clinic providers. Since both are reimbursed based on their costs, he said, these would be effective economic incentives for expanding pregnancy-related services in underserved areas.
The Illinois News Connection originally published this story.
