Two trends are having a noticeable impact on maternity and women’s health services nationwide: (1) a reduction in overall number of births, along with a declining birth rate, and (2) the rising number births to women over age 35, or advanced maternal age mothers. (Learn more about these trends in a recent blog post.) Considering decreasing volumes and the increasing financial burden of maintaining a specialized OB service line, many hospitals are choosing to deemphasize or even close their OB units and instead focus on more profitable, growing service lines, such as neuroscience or cardiac services. While many hospitals have closed their L&D units (mostly in rural areas—almost 10% of rural hospitals closed OB units between 2010 and 2014), most hospital executives consider women’s services to be both a core community hospital offering and an essential entry point for new patients.
OB services are somewhat unique in that they are highly influenced by patient choice, although patients may be limited by payer coverage and physician privileges. A pregnant woman will have many months to decide which facility best caters to her unique situation and birth plan. Long before they are actually pregnant, many patients will begin to explore OB options by selecting insurance plans that may have particular providers or hospitals in their networks. To maintain and grow OB services, providers will need to appeal directly to patients. In addition, many states (most recently, Texas) are implementing regulations and certifications for maternal care programs, requiring facilities to achieve a maternal care designation (similar to a trauma or NICU designation) or lose Medicaid funding. Although the range of potential strategies is wide and will be market dependent, each hospital should consider completing a comprehensive reevaluation of its OB/GYN program, which would involve:
- Assessing market demographic trends and consumer demands.
- Evaluating facility, equipment, and staffing resources for the potential to offer alternative services or add operational efficiencies.
- Considering physician partnerships and opportunities to improve alignment and coordination.
- Developing marketing, communication, and brand awareness.
- Integrating with infants’, children’s, and broader women’s services.
Table 1 outlines some of these strategies in greater detail; as the maternity services market continues to evolve, facilities and service lines are continually exploring unique ways to differentiate services and meet consumer need.
Planning for the Future of Maternal Care
Moving forward, convenient access, improved patient and physician experience, and subspecialty services such as MFM medicine will be common themes across the various strategies for competing in maternal care. As the OB patient population ages and contracts, providers will need to act proactively to improve experience and convenience in maternal care service lines, as well as to protect and gain market share, while creating lasting relationships with patient families.