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Banks-Jackson-Commerce Medical Center will leave the baby business

POSTED: November 22, 2008 5:00 a.m.

Banks-Jackson-Commerce (BJC) Medical Center has announced it will stop delivering babies as of Dec. 9.

Henry Slocum, spokesman for BJC, said the 90-bed Commerce hospital has been struggling financially.

"We had $2 million in bad debt last year, and it’s hard for small hospitals to absorb something like that," he said.

In the past, obstetrics was usually a moneymaker for hospitals. But those days are gone.

"Medicaid doesn’t pay enough," said Slocum. "And we have not been delivering enough babies for the department to pay its way."

Last year, 66 babies were delivered at BJC. Slocum said there are only three physicians who admit maternity patients to the hospital. One is an obstetrician-gynecologist; the other two are general family practitioners who occasionally deliver babies.

Slocum said eight people are employed full-time in labor and delivery at BJC. "They can apply for jobs in other departments (after Dec. 9), but those may not be the types of jobs they want," he said.

Kevin Bloye, spokesman for the Georgia Hospital Association, said BJC is the second hospital in Georgia to give up on obstetrics this year. Evans Memorial Hospital in Claxton has announced it will quit delivering babies as of Dec. 31.

"It’s a tough time to be a rural hospital," Bloye said. "The important factor is payer mix. In rural areas especially, the base of insured patients is shrinking. You need to have enough insured patients to offset the cost of treating Medicaid and uninsured patients."

Bloye said all hospitals have seen a decrease in their profit margin for labor and delivery.

"Medicaid is paying less and less for those services, and there are more Medicaid patients now," he said.

But even as some hospitals are getting out of the baby business, others are expanding their maternity services. In August, Northside Hospital Forsyth opened a brand-new Women’s Center and began delivering babies for the first time.

And just two weeks ago, Northeast Georgia Medical Center in Gainesville opened its $50 million Women & Children’s Pavilion, which is capable of delivering up to 7,000 babies a year.

Medical center spokeswoman Cathy Bowers said 3,947 babies were delivered in the fiscal year that ended Oct. 1. Now that the new facility is open, it’s expected to draw more maternity patients from the 14-county region the hospital serves.

"Already, 34 percent of our deliveries are from (patients who live) outside Hall," Bowers said.

It’s likely that some of those new customers are expectant mothers who previously would have considered giving birth at a smaller hospital such as BJC.

Bowers said in the past year, Northeast Georgia Medical Center delivered 65 babies from Banks County and 233 from Jackson County.

She said the medical center is working with BJC to assist any expectant mothers whose due date is later than Dec. 9 and are looking for another hospital at which to give birth.

But if maternity services aren’t profitable for hospitals, why are some of them putting so much emphasis on it?

For Northeast Georgia Medical Center, the key is an economy of scale. Each week, the Gainesville hospital delivers about the same number of babies that BJC delivers in a year. This allows a greater efficiency of operation and also gives the hospital enough insured patients to compensate for the ones who are on Medicaid.

The Women & Children’s Pavilion also has an advanced neonatal intensive care unit. A high-risk NICU is a money drain on a hospital, because treating a very premature infant can cost hundreds of thousands of dollars.

On the other hand, having a NICU attracts both doctors and patients, who may feel more comfortable delivering at a facility that can treat the baby if something goes wrong.

Bowers said 19 obstetricians and 11 nurse-midwives have delivery privileges at the medical center.

Slocum said BJC may someday revive its maternity unit if more doctors are interested in working there.

"If an OB/GYN decides to relocate to this area and wants to deliver here, we might consider reopening," he said.



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