Dear Friends:
    Thanks to all who post about their states  individual practices. 
Connecticut sounds much more forward thinking than  Pennsylvania.
    In the Philadelphia, PA area, the care for new moms  and babies is 
incomplete, to say the least. The agencies that get reimbursed by  the insurance 
companies receive $60 for a mother-baby visit; the agency keeps  $20. The nurse 
gets $40, which works out to about $10/hour when one factors in  travel time 
and paperwork in addition to the actual visit.
    Only 4 insurance companies will pay for a LC visit  postpartum; the 
companies do not tell their subscribers that this service is  available. The 
mothers have to call their case manager and ask. Once in a while,  a mother can 
persist and get a second LC visit authorized.
    There is no system in place that will reach every  new mother; some 
mothers are lucky with their insurance to get a  well-mother/well-baby visit. 
Others get nothing. There is no place that  offers the service, unless a family 
wants to pay for it themselves; a visit is  so expensive for families that they 
almost never buy one.
     Two insurances will pay for 2  wellmother/wellbaby visits, which is 
great for the dyad as the mom can learn how  well her baby is growing.
    Mothers and babies are at the bottom of the list;  in July, yet another 
hospital in PHiladelphia will close its maternity unit, as  it is too expensive 
to run and the reimbursement doesn't cover the expenses. 
    The Philadelphia area is but one small portion of  the large state of 
Pennsylvania; I don't know how things are in the rest of the  state.
    warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct  Faculty Union Institute and University
Film Reviews Editor, Journal of Human  Lactation
www.breastfeedingalwaysbest.com

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