(Radio Iowa) – A report finds only about one third of rural Iowa hospitals now deliver babies, with three hospitals closing their maternity wards in recent years, and two more considered at risk. Harold Miller, president and CEO of the nonprofit Center for Healthcare Quality and Payment Reform, says rural hospitals often lose money running expensive OB units with few births.

“What’s been happening increasingly is that small rural hospitals are losing money overall,” Miller says, “so they don’t have any profits to be able to subsidize labor and delivery services.” Miller says a major driving factor is commercial insurance reimbursement rates.

“The private commercial insurance plans are not paying enough for labor and delivery services in rural hospitals, and they’re not paying enough for other kinds of services in the hospitals,” he says, “which is what’s causing the hospitals to have overall losses.”

The report says Iowans who have to go to an alternative hospital to give birth have a median travel time of 32 minutes.