Billing shift won’t solve maternity care deserts in Illinois

(Illinois News Connection/Public News Service)

A health-care expert in Illinois questions whether changes to the way doctors report and bill for pregnancy-related services will expand access to maternal care.

The American Medical Association is shifting from a global payment system to itemized billing for prenatal and delivery services. Charles James, president of North American Health Care Management Services, said the update is needed to modernize standards. He said he hoped it would improve access to pregnancy services for families, but added it misses some important points.

Despite some tweaks in 2009, James said billing practices for pregnancy services haven’t been updated since the mid-1990s. The changes will go into effect in January 2027.

Rural hospitals in Illinois continue to struggle to maintain OB departments. More than 100 rural hospitals in Illinois have closed or made plans to close their maternity units since 2020.

James said the effort to address these health-care deserts requires more commitment, as these services cost more to provide in rural communities.

James suggested policy solutions such as waiving bed limitations for critical access hospitals or implementing payment premiums for rural health clinic providers. Since both are reimbursed based on their costs, he said, these would be effective economic incentives for expanding pregnancy-related services in underserved areas.

Judith Ruiz-Branch, Illinois News Connection

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Judith Ruiz-Branch is an award-winning journalist with over a decade of experience as a reporter/producer for TV, radio, print and podcast news. She's also served as a Spanish spokesperson and led communications, media and public relations team's at various organizations in Chicago. She began her career at WGN-TV in Chicago and went on to work for various news outlets including WBEZ Radio, Crain's Chicago Business, the Chicago Tribune and WNIN Tri-State Media among others. Her bilingual reporting with WNIN earned her two Murrow Awards, most recently for innovation in the digital space. Her favorite stories to report on are health, human interest, equity, justice, and immigration.

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