Birth center could face axe 

Plans for a new birthing center at the county hospital — originally conceived as a revenue source — could be scuttled due to reductions in Medi-Cal reimbursements, leaving hundreds of expectant mothers to continue delivering their babies at surrounding hospitals.

The $9.8 million renovation to an unused wing of the San Mateo Medical Center, which was put out to bid in December, has been shelved until the county hospital board reviews the latest cost estimates, according to Board of Supervisors President Jerry Hill.

"I don’t see the birthing center penciling out [fiscally] in the future," Hill said.

Originally expected to make money, the birthing center could now cost the medical center around $14 million a year due to possible cuts in Medi-Cal reimbursement for new health services, according to a county report. An alternate, and more difficult to realize, scenario that would require the county to negotiate a cost-sharing agreement with the state would mean essentially breaking even, according to the report.

The likely demise of the birthing center is an example of the chaos in the health care industry today, where a curveball by the state or federal governments on reimbursement rates can have wide-ranging impacts at the county level, Hill said. "It doesn’t look like it’s something we should take a chance on," he said.

The medical center, which provides prenatal care for as many as 1,000 of the county’s 2,300 Medi-Cal births a year, has no obstetrics center. That forces expectant mothers to deliver their newborns at surrounding hospitals, often among doctors they don’t know, officials said. One of the goals of the renovation is to give women one continuous stream of care from before birth until after birth, a service for which a demand has been demonstrated, medical center spokesman Dave Hook said.

Prior to the reductions in Medi-Cal reimbursements — which took effect for the first time this year — medical center officials estimated that a birthing center would bring in hundreds of thousands a year, helping to somewhat offset more than $55 million in county subsidies for the public hospital each year, Hook said.

Finding new revenue sources as well as pressuring area nonprofit hospitals to increase their charity care giving has been a major focus for Hill, who sits on the county hospital board. The county estimates subsidies to the medical center will cost as much as $65 million in fiscal 2006-07.

The obstetrics renovation plan includes eight private postpartum rooms, an operating room for emergency C-sections and a level-2 intermediate care unit for babies, according to Hook.

ecarpenter@examiner.com

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