To examine the availability of inpatient maternity care in rural hospitals serving Medicaid enrollees.
Approach:
Data Analysis: Utilized 2023 T-MSIS, 2020 USDA RUCA codes, 2025 CMS hospital enrollment records, and 2021 AHA Annual Survey data to analyze the distribution and access to inpatient maternity care in rural hospitals.
Key Findings:
In 2023, 943 rural hospitals provided inpatient maternity care to Medicaid enrollees, accounting for 39% of all hospitals offering such services nationwide.
The median travel time to the nearest in-state hospital providing inpatient maternity care is 43 minutes for rural hospitals, compared to 13 minutes for urban hospitals.
In 14 states, the typical travel time from rural hospitals to the nearest in-state hospital providing maternity care is at least one hour.
Interpretation:
Access to inpatient maternity care in rural areas is limited, with significant travel times to the nearest facilities, which may worsen with potential hospital closures.
Limitations:
Data quality concerns led to the exclusion of hospitals in Georgia and Rhode Island.
The analysis does not account for variations in care quality or outcomes based on hospital location.
Conclusion:
The findings highlight the challenges faced by Medicaid enrollees in rural areas regarding access to inpatient maternity services, particularly in light of potential future reductions in Medicaid funding.
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