Despite critics pointing to the role they played in the passage, doctors could be a blueprint for caesarean sections at non-hospital clinics in Florida’s recently enacted Florida The law could be a blueprint for other states.

Hospital workforce and delivery forces are closed nationwide due to economic tensions as the US has lower maternal health outcomes compared to fellow countries. Advocates say Florida laws can increase access to obstetric care and reduce the costs of expecting patients.

However, critics, including some doctors, hospitals and midwives groups, have warned that it is an untested model that could put mothers and babies’ health at risk. They also take note of private equity companies that have made other forays into healthcare. It attracted national scrutiny It is said that benefits are more important than patient safety.

Columbia University researcher Alex Bolsa, a researcher focused on the healthcare impact of private equity, said he was not surprised that Florida has become a testing ground for such a clinic .

“In addition to Florida being Wild West with many policy directions, we have one of the highest concentrations of healthcare operators backed by private equity, including OB-Gyn and fertility,” Bolsa said. Ta.

Traditional birth centers usually have midwives providing obstetric care for low-risk pregnancies and births. These centers operate in Florida, with around 400 licensed nationwide. The focus of these centers is on natural births in a natural environment where women are present in the vagina without anesthesia and give birth to the vagina.

Florida law creates a new designation called “Advanced Birth Centers,” allowing doctors to provide labor and delivery services in independent clinics that include a caesarean section. There are no such centres at the moment. The C-section is a surgical procedure performed under anesthesia, in which the baby reaches by incisions of the patient’s abdomen and uterus. The C-section is generally reserved for situations where doctors believe that vaginal birth can be at risk for the mother or baby.

However, in recent years, a group of private equity-owned doctors known as Women Care Enterprises has been lobbying for new designations from Florida lawmakers. Owned by London-based investment firm BC Partners, the group operates around 100 clinics in Florida, with dozens more operating in California, California and Kentucky.

The new designation was hidden within a larger health policy invoice Despite opposition from medical and midwifery groups, it became law.

“Both moms and babies deserve access to the best possible care, so doctors, interdisciplinary teams, sophisticated equipment and other important resources can be used immediately in the complexity of the event. We believe that C-sections need to be implemented in a possible hospital setting. Mary Mayhew, president and CEO of the Florida Hospital Association, told Stateline in a statement.

However, the association had not fought the bill, which, among other things, increased Medicaid payments to hospitals for obstetric care. Other groups opposed it.

“We call lions a tiger, so we’re primarily against it,” said Kate Bauer, executive director of the American Birth Association, a nonprofit that sets national standards for birth centers.

She noted that although advanced birth centers provide birth care outside of hospital settings, they are not the same as traditional midwifery capacity-based birth centers. Midwife births are intended for people with low-risk pregnancies, and tend to focus on low-intervention care and emphasize natural birth techniques. The births that doctors give birth tend to rely on more advanced medical interventions, such as epidural anesthesia and labor-inducing medications.

Private equity jumps in

Florida lawmakers say they are helping to designate a new, advanced birth center. just two Of Florida’s 22 rural hospitals, there are labor and delivery services.

Staff members of Florida Sen. Gail Harrell, a Republican who sponsored the bill, said they could not comment on Stateline. However, at previous committee hearings, Republican legislators announced the Center as an innovative solution for obstetric care.

“I think what we’re hearing from the medical community is a desire for options,” Republican Sen. Colleen Burton said in December 2023. Committee hearing About the bill. “And what we hear most is patients from Florida. [who want] option. And potentially this could offer a low-cost option. ”

But critics say that already lacking in Florida, OB-Gyns is likely to open advanced birth centers in low-income and rural communities where more share of patients have Medicaid I’m questioning what you’re saying. Government sponsored insurance provides a significant refund of obstetric care physicians compared to private insurance.

Columbia University’s Bolsa co-authored a 2020 study that discovered the OB-Gyn office owned by private equity It is likely to be located in an urban area Median household income is above the national average.

Private equity companies use pooled money from investors to buy control over the company. They usually focus on increasing the value of the company with profits, ideally before selling within a few years. Over the past decade, private equity investors have spent buying $1 trillion healthcare companies.

Bolsa said he and his colleagues had Strong evidence found Private equity involvement in healthcare “is quite consistently increasing costs for patients and payers.”

“There’s a fantasy about Wall Street investors somehow increasing access in some of the country’s most rural and poor parts of the country, but I haven’t seen any evidence of that,” he said.

In recent years, private equity involvement in the healthcare industry has attracted public outrage Legislative scrutiny. For example, earlier this month, the US Senate Budget Committee Report It details how private equity companies narrow down hundreds of millions of people from hospitals they struggle with.

Dr. Helen Kuroki, chief medical officer for women’s care companies, declined to comment on supporting the new law and when it could open a senior birth center. Representative has I said earlier They are looking to open the center in Tampa or Orlando.

Labor and delivery services tend to be hospital financial losers, especially thanks to low reimbursement rates from Medicaid. Medicaid covers many people in rural areas half Of all births, the refund does not cover the entire cost of providing obstetric services.

If patients covered by better paying private insurance flock to independent birth centers that can perform C-sections, it leaves the hospital with a higher percentage of Medicaid patients. Owning surgical space also allows groups of doctors, such as women’s care companies, to maintain more reimbursement dollars they normally plan to go to hospital.

Like a surgical center – a type

Supporters compared Florida’s new birth center model with outpatient surgery centers. There, patients undergo surgical procedures that do not require an overnight hospital stay. Patients who receive the C-section can stay overnight at a new birth center.

The hospital is blocking much-needed birth centers in the south

However, critics argue that C-sections are essentially different from cataract surgery or tonsillectomy, for example.

“We’ve seen that outpatient surgery centers can successfully deliver healthcare delivery models,” said Bauer of the Birth Centers Association. “For me, the main difference is that surgical birth is the only operation and there are extra people when you’re done. And that’s the extra people that may be hurting your health.”

Some Florida lawmakers have expressed concern that if problems arise after birth, pediatric specialists will not need to be taken care of by the new center. The center must have written agreement with the local hospital to relocate patients with complications. You must also follow most outpatient surgery center safety standards.

So far, Florida has remained an outlier. Lawmakers from other states have yet to implement similar bills.

But as private equity companies become more involved in women’s health and other health sectors, Bolsa hopes they will strengthen their lobbying of state legislators and win favorable policy changes.

“We were able to see more healthcare lobbying, specifically, elsewhere in the country,” he said. “I don’t think this is a one-off if you think you can benefit from it, especially if you think it’s possible.”

Stateline It is a nonprofit news network that is part of the state newsroom and supports a coalition of grants and donors as a public charity of 501C(3). Stateline maintains editorial independence. For questions, please contact editor Scott S. Greenberger. [email protected].