Worcester Business Journal

wbjournal.com | August 21, 2023 | Worcester Business Journal 13 TICKETS & SPONSORSHIPS ARE AVAILABLE AT YWCACM.ORG/TRIBUTE Tuesday, September 12, 2023 12:00 to 1:30 PM Mechanics Hall 321 Main Street, Worcester, MA 2023 KATHARINE F. ERSKINE AWARD RECIPIENTS Arts & Culture Nayana LaFond Artist and Curator Business & Law Jill Green Lebow Chief Human Resources Officer, Fallon Health Community, Social Services & Government Susanne Ryan Fiber Artist and Co-founder of Sisters in Stitch Joined by the Cloth (SISJBTC) Quilt Guild Education Ivonne Perez Chief Diversity Officer, Worcester Public Schools Health, Science & Technology Debra Maddox, Psy.D. President and CEO, Multicultural Wellness Presenting Sponsor Media Sponsor Partner Sponsor Leominster maternity should stay open Citing workforce shortages and the highly demanding nature of maternity care, UMass Memorial Health in May announced plans to close its maternity ward at the HealthAlliance-Clinton Hospital, Leominster Campus. The closure, pending regulatory approval, would occur in late September, but lawmakers and community members have protested the decision, expressing they believe it will harm those seeking maternity services in North Central Massachusetts, as it increases the distance they must go for maternity care. When polled online, more than two-thirds of WBJ readers said the maternity center should stay open. Should UMass Memorial be allowed to close the Leominster maternity center? F L A S H P O L L Yes, the healthcare industry is going through a difficult time and tough decisions need to be made. 22% 10% Yes, especially if it improves the overall financial health of the UMass Memorial system. No, maternity care is a vital service and needs to be preserved. 34% No, and the state or federal governments should provide additional funding to keep the center viable. 34% COMMENT "Oh yeah, the state and federal governments are loaded." - Horacio Smith maternal morbidity. Irene Hernandez, a resident and healthcare professional who co-chairs the coalition opposing the Leominster unit closure, said her own daughter had been otherwise healthy when, at 25, she nearly died giving birth due to a complication causing severe bleeding. Had she not made it to HealthAlliance for an emergency C-section, Hernandez said her daughter and grandson would have died. Hernandez now worries about low- income mothers who don't have reliable transit to travel to Worcester for hospital care and suspects UMass Memorial is shiing away from such patients for financial reasons. "When low-income people have babies, the compensation rate from MassHealth [the state's Medicaid program] just breaks even," she said. A risky business Dickson, though, insisted the decision to close labor and delivery at HealthAlli- ance-Clinton was chiefly clinical. At issue, he said, is hiring enough doc- tors to safely staff the unit. Obstetricians are oen hesitant to deliver in a small community hospital, preferring larger hospitals with specialist care around the clock to handle emergencies and more complicated cases. For that reason, it's been a struggle to build out the OB-GYN practice in Leominster. Related to this, Dickson said, is the fact the risk of med- ical malpractice suits for obstetricians is higher than other specialties. "It's a risky business. One delivery goes wrong, one bad outcome, is a big prob- lem for an obstetrician," Dickson said. HealthAlliance-Clinton is hardly an outlier. Elsewhere in Massachusetts and across the country, the number of hospi- tals delivering babies has fallen, adding to a phenomenon known as maternity deserts, defined by the nonprofit March of Dimes as U.S. counties without access to labor and delivery care. No region of Massachusetts is classified as a maternity desert, and the March of Dimes calls it a full-access state, given every county has two or more hospitals offering services, or 60+ providers per 10,000 births. Yet, 10 hospitals have closed their labor and delivery units since 2010. In Central Massachusetts, those include the former Baystate Mary Lane Hospital in Ware and UMass Memorial Harrington Hospital in Southbridge. Central Massa- chusetts is still home to six other hospi- tals, including UMass Memorial Medical Center in Worcester and Saint Vincent Hospitals in Worcester, with labor and delivery services. Nationally, at least 89 hospitals closed obstetric units between 2015 and 2019, and almost half of rural hospitals didn't offer obstetric services, according to the American Hospital Association. Operating at a $4M loss Despite Dickson's insistence the closure is not about money, Medicaid payments, which are about one third the rates paid by commercial insurers for hospital births, are an underlying factor putting pressure on the bottom line. HealthAlliance-Clinton is among Massachusetts hospitals with a high public payer mix, meaning a majority of patients are insured by Medicaid. Such populations may not support the kind of investment in obstetrical programs hospitals in more affluent areas do. Labor and delivery services at HealthAlliance-Clinton aren't solvent, Dickson said. e unit finished fiscal 2022 with a $3.74-million operating loss. But he said by redirecting the care of those patients to Worcester, the system is simply moving a money-losing book of business from one hospital to another. Cost pressures on healthcare systems are forcing difficult decisions, and Med- icaid-heavy programs, such as mater- nity care, will take a hit, Dickson said. "Change, or you're going to fail," he said. Tenet reverses Framingham shortage Another area hospital that's struggled with staffing its labor and delivery unit is Metrowest Medical Center in Framing- ham. e Tenet Healthcare-owned sister of Saint Vincent Hospital in Worcester faced a registered nurse shortage late last year, said Dr. Michele Sinopoli, an OB-GYN who serves as chief medical officer for Saint Vincent and Metrowest Medical Center. When the work- force isn't stable, Sinopoli said doctors are hesitant to deliver at a hospital, but Tenet doubled-down on hiring and training new nurses to work in labor and delivery, a specialty traditionally harder for new nurses to break into. Meanwhile, the system hired a group of laborists: doctors who work only in labor and delivery and don't have to spend any time outside the hospital at outpatient clinics. Together, these have stabilized labor and delivery operations. Like UMass Memorial, many Metrow- est patients are covered by Medicaid and face some of the same issues that Leominster-area mothers do, such as lack of transportation to a Worcester hospital. "We were very emphatic about that … We have no intention of closing the labor and delivery unit at Metrowest Medical Center. It's incredibly important to the community, especially those with trans- portation issues," Sinopoli said. Irene Hernandez, co- chair of Community United to Save Our Birthing Center Dr. Michele Sinopoli, chief medical officer, MetroWest Medical Center W

• Cover