TITLE: 'Deny, deny, deny': By rejecting claims, Medicare Advantage plans threaten rural hospitals and patients, say CEOs
https://www.nbcnews.com/health/rejecting-claims-medicare-advantage-rural-hospitals-rcna121012
EXCERPT: For decades, Rose Stone counted on the Alliance HealthCare System in rural Holly Springs, Mississippi, for her medical needs. But after she retired and signed up for a Medicare Advantage plan, she was surprised to learn it didn’t cover her visits to nonprofit Alliance, the only health-care provider within 25 miles. Stone had a choice: use her own money to keep seeing her regular doctor or drive out of town to see a physician she didn’t know but whose costs were covered.
“It was a mess,” Stone told NBC News. “I didn’t go to the doctor because I was going to have to pay out-of-pocket money I didn’t have.”
Some 31 million Americans have Medicare Advantage plans, private-sector alternatives to Medicare introduced in 2003 by Congress to encourage greater efficiency in health care. Just over half of Americans on Medicare are enrolled in one of the plans offered by large insurance companies, including UnitedHealthcare and Humana.
Problems are emerging with the plans, however. Last year, a federal audit from 2013 was released showing that 8 of the 10 largest plans had submitted inflated bills to Medicare. As for the quality of care, the Medicare Payment Advisory Commission, a non-partisan agency of Congress, said in a March report that it could not conclude Medicare Advantage plans “systematically provide better quality” over regular Medicare.
Even worse, because the plans routinely deny coverage for necessary care, they are threatening the existence of struggling rural hospitals nationwide, CEOs of facilities in six states told NBC News. While the number of older Americans who rely on Medicare Advantage in rural areas continues to rise, these denials force the hospitals to eat the increasing costs of care, causing some to close operations and leave residents without access to treatment.
“They don’t want to reimburse for anything — deny, deny, deny,” Dr. Kenneth Williams, CEO of Alliance HealthCare, said of Medicare Advantage plans. “They are taking over Medicare and they are taking advantage of elderly patients.”
TITLE: More maternity wards closing in Alabama forcing women to find other healthcare options
https://www.wbrc.com/2023/11/02/more-maternity-wards-closing-alabama-forcing-women-find-other-healthcare-options/
EXCERPT: In the past month, two hospitals in Alabama ended their OB programs with one more closing soon forcing women in a state with one of the country’s highest maternal mortality rates to find other healthcare providers.
Shelby Baptist Medical Center and Princeton Baptist in Birmingham are no longer delivering babies. Come mid-November, Monroe County will join the growing list of labor and delivery departments closing. The head of the Alabama Hospital Association says hospitals have either been extremely short on personnel or have lost a lot of money from uninsured patients.
“When you’ve got hospitals that are struggling to make payroll and they’re losing money on delivery services and you’ve got a shortage of providers it becomes very difficult,” Dr. Don Williamson, President of the Alabama Hospital Association said.
The OB programs closing means some women in rural areas may have to drive up to 40 miles or more for prenatal care. In rural Alabama, access to transportation remains one of the biggest challenges in getting adequate healthcare.
Williamson says expanding Medicaid could help rural hospitals which would cover families in the gap and possibly keep the OB doors open.
“If we do that, we’ll save rural hospitals, provide them with enough resources so that they are able to keep open lines of service that they otherwise may have to close,” Williamson said.
TITLE: Infant mortality rate increases 3% in 2022, rising for 1st time in 2 decades: CDC
https://abcnews.go.com/Health/infant-mortality-rate-increases-3-2022-rising-1st/story?id=104505952
EXCERPT: Dr. Tracey Wilkinson, an associate professor of pediatrics at Indiana University School of Medicine who is an expert on women's access to reproductive health care, told ABC News she's not surprised by the findings and that she sees a couple of reasons for the increase in infant mortality rates.
One is maternity care deserts -- where’s there a lack or absence of maternity care -- which limits the ability to care for infants properly. The second is limiting of access to abortion, particularly following the Supreme Court decision of Dobbs v. Jackson in June 2022, which overturned Roe v. Wade.
"Any pregnancy that is intended and planned tends to be a healthier outcome and healthy infant outcome," Wilkinson, who was not involved in the report, said. "So, when you remove the ability for people to decide if and when to have families and continue pregnancies, ultimately, you are having more pregnancies continue that don't have all those factors in place."
She added, "Furthermore, we are hearing over and over again, women with non-viable fetuses with diagnoses that mean that they will not survive outside of the womb for any significant period of time, being forced to continue those pregnancies. And so that will also contribute to infant mortality because once those infants are born, they're counted in these numbers."
A recent analysis from ABC News and Boston Children's Hospital found more than 1.7 million women, nearly 3% of women of reproductive age in the U.S., live in a county without access to abortion and with no access to maternity care.