PARIS, Tn. (WTVF-TV) — There is what some are calling "a crisis in care" right now in Henry County.
Doctors who deliver babies at the Henry County Medical Center received termination notices earlier this week.
They're being let go because the hospital has decided that it has no choice but to close its Ob-Gyn department, a move some say will put the lives of both women and babies in danger.
So what's behind this closure?
There are people who blame TennCare. Then there's BlueCross BlueShield, the TennCare provider that some say is putting money over medicine.
But as we found, there's a lot of blame to go around.
Two hours outside of Nashville, in the small town of Paris, perhaps best known as home of the world's biggest fish fry, just about everybody. knows someone who was born at the Henry County Medical Center.
But that's about to change.
The hospital recently announced it is closing the ob-gyn department here.
Hospital CEO John Tucker said, "You just cannot provide that service for what our (TennCare) payment rates are."
70% of the women who deliver at the Medical Center are on TennCare and most of them are enrolled in the BlueCross BlueShield program known as BlueCare.
In 2002, state lawmakers passed a law declaring TennCare reimbursement rates proprietary information and therefore confidential, meaning hospitals are not allowed to discuss how much they get from BlueCare.
But hospital administrators in Henry County are so concerned, they decided to break the rules so the public can understand their predicament.
"You haven’t had an increase (in reimbursement rates) in years? " NewsChannel 5 Investigates asked Tucker.
"Right," he replied.
"And healthcare costs have gone up?" we continued.
"Right. Extraordinarily, yes," Tucker stated.
BlueCare pays the Henry County Medical Center $1734 for a mother to stay in the hospital and deliver her baby and an additional $335 to care for that baby once it's born.
There's kind of a running joke among hospital folks that it costs more ($350) to stay at the nearby Paris Landing State Park lodge than BlueCare pays ($335) for a full-term healthy newborn.
Longtime Henry County physician and Henry County Medical Center Board member Dr. Scott Whitby laughed as he shared that tidbit and exclaimed, "It's crazy!"
But most agree it's no laughing matter that Blue Care has been paying Henry County the same rates since 2019.
And Blue Care is actually paying substantially less now than it was for the very same services back in 2009 when it paid $2734 for a delivery and $405 for newborn care.
We asked BlueCross why, but they refused to answer.
When we shared this information with Michele Johnson, the executive director of the Tennessee Justice Center, her reaction was, "Holy smokes! I mean obviously there’s been lots of healthcare inflation since 2009!".
The Tennessee Justice Center is a non-profit public policy and advocacy organization and law firm that represents TennCare patients.
And Johnson was shocked to hear the Henry County Medical Center is being forced to eliminate its obstetrics program because the TennCare reimbursement rates don't come close to the actual costs.
"It’s immoral that we have a government that is responsible and...they don’t roll up their sleeves and say we have to solve this. This is a crisis!" Johnson said.
Hospital administrators thought so too. They recently turned to TennCare for help.
"The response was, 'Well, you’ve signed a contract and have accepted those rates. If you want better rates, just go negotiate with them,'" CEO John Tucker recalled.
But Tucker said for a rural hospital like Henry County, that's easier said than done.
"With small independent facilities, there’s just not a lot of ability to negotiate. If you’re a Saint Thomas or a Tri-star system, you have a lot more leverage," Tucker said.
And what makes it even trickier is that 2002 state law that makes TennCare reimbursement rates confidential.
"So you don’t know what other hospitals are getting or how that compares?" NewsChannel 5 Investigates asked Tucker.J
"I don’t," he confirmed.
"It’s not a fair fight," the Tennessee Justice Center's Johnson remarked.
She also found it concerning that with Blue Cross, the rates essentially don't change unless the hospital comes back and asks for more money.
"Why is the burden on this little hospital to say we really want to take care of these patients?" she wondered.
Henry County concedes they have not asked for a rate increase in 4 years, in large part because they were focused on Covid and had a lot of turnovers, replacing a CEO and losing several other administrators,
But in early June, the hospital asked BlueCare to significantly raise its reimbursement rates for maternity care.
And while a BlueCross spokesperson told NewsChannel 5 Investigates, "Whenever we receive a rate request from a provider, we give it our full consideration,".more than a month after Henry County's request, BlueCross is still "considering" it.
Dr. Scott Whitby said, "I am confident other hospitals are getting a lot more than us for the identical service."
Longtime doctors in Henry County, like Whitby and Dr. Pamela Evans, one of the hospital's obstetricians, are frustrated.
Evans said, "I think if you really cared about women and babies, you would compensate equitably... It’s not a hospital that’s asking for more than a share, but it’s an obstetrical unit that’s asking to be treated fairly."
Several years ago, Blue Cross spent $750,000 to build a large playground in the city's Eiffel Park.
Blue Cross even promotes it on its website. as a state-of-the-art outdoor recreational and fitness space.
But who will play on that playground, some ask, in a couple of years if the hospital stops delivering babies in September?
Michele Johnson said that's on the state and TennCare.
"They can’t slough that off on Blue Cross. They can’t push that off on Henry County negotiations. They can’t give it to pregnant women and say you know fight for your prenatal visits. They (TennCare) are ultimately responsible, and they have a duty to fix what is broken," Johnson said.
Both TennCare and BlueCross turned down our requests for an interview.
Keep in mind, as folks in Henry County point out, babies are going to continue to be born. And when Henry County closes its ob unit, mothers will simply have to go elsewhere to deliver where it's likely BlueCross pays more for services so in the long run, BlueCross will end up having to spend more money one way or another.
As far as pregnant women in Henry County now, they're scrambling. Most have doctors there they love and have been going to for a while. They don't want to leave them. But they can't wait until September 1st to look for a new one. A lot of doctors, in fact, won't take you as a new patient if you're more than 12 weeks along. And if you're on TennCare, we're told, trying to find an ob is even more challenging.
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