<< Back 10/16/02 As delivery costs rise, doctors seek county help By Scott McLeod Haywood County’s two obstetricians have asked the county to increase the local supplement they receive for delivering babies for patients who pay with Medicaid. “Not only have we experienced this increase in the basic cost of malpractice insurance, our carrier increased their requirements on liability limits required for obstetricians,” the doctors of Haywood Women’s Medical Center wrote in a letter to Health Department Director Bob Wood. Those two factors, wrote Drs. Chris Lane and Robin Matthews, have driven up their malpractice insurance for obstetrics 102 percent in the past year. That hike added about $102.86 to the cost of every delivery based on the 2001 figure of 317 deliveries for the practice. “Many obstetricians are closing their practices due to financial and personal risks,” they wrote. In Haywood County, Lane and Matthews are the only medical doctors who regularly deliver babies. Their practice also includes three nurse midwives. Medicaid reimburses physicians $1,400 for delivering babies, a rate that was decreased this year from $1,475, said Wood. For more than a decade, the county has reimbursed Haywood Women’s Medical Center for their Medicaid deliveries in order to ensure that low-income women in the county would continue to have obstetrical care. Right now, the county provides the practice $300 for each Medicaid delivery. They are seeking an increase to $400. “Last year there were 183 Medicaid deliveries in the county,” said Wood. “This would bring the supplement up another $18,000.” Because it accepts every patient regardless of their ability to pay, Haywood Women’s Medical Center has a high percentage of Medicaid deliveries. In 2001, 71 percent of the mothers using the practice used Medicaid as their primary or secondary insurance coverage. County commissioners tabled the request, asking Wood to bring them more data about the request. “I am certainly appreciative of the service this medical practice provides,” said Commissioner Mary Ann Enloe. “Doctors are just not delivering babies anymore, and insurance is the reason.” Wood told commissioners that in Haywood County it is common practice for almost all women with insurance to go out of the county for obstetrics services. He also said Haywood is the only county in this part of Western North Carolina that provides a supplement to an ob/gyn practice.