Since I began practicing over 23 years ago, I have accepted Medicaid reimbursement because I believe that every birthing person and their family deserves the care and the birth they desire, regardless of income or ability to pay. Unfortunately, with decreased reimbursement and increasing expenses, accepting Medicaid for home birth care has become unsustainable for my practice.
Medicaid can work for large group practices where the lower rate of reimbursement can be offset by taking on more patients, a business model that is impossible for a small midwifery practice. The level of commitment and the amount of time invested in providing individualized and personal care, the very essence of midwifery, cannot be provided on a large scale.
I remain committed to serving those covered by Medicaid and by limiting my care to prenatal and postpartum services I will be able to care for many more families with the same comprehensive midwifery model of care.