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Making Women's Health Work

Elyas Bakhtiari, for HealthLeaders Magazine, March 8, 2010
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Perinatology may in fact be one of the fastest-growing segments of obstetrics, due to an increasing maternal age and a growing prevalence of obesity, diabetes, and other health factors that can complicate births. Growth in assisted reproduction technologies and new screening methods for fetal chromosomal abnormalities may also change the market.

Preparing for this demand requires more than adding NICU beds; hospitals may need to recruit additional maternal-fetal specialists (which are in fairly short supply) or add postpartum beds, high-tier ultrasound machines, and other equipment.

Korth also recommends gynecological surgery services to improve the women's health payer mix. These tend to be elective, unlike high-risk OB, but insurers reimburse well for them, she says. Although inpatient gynecology volume appears to be headed down nationwide, there is still growth in outpatient demand, and minimally invasive programs offer new opportunities. Hospitals are also increasingly handling a lot of gynecology surgeries with da Vinci surgical robots, which can be a draw for patients.

Success Key No. 2: Work across disciplines
Another way to make women's health more profitable is to make it more than obstetrics and gynecology. Women's health is evolving into a multidepartmental service line, carving out niches from some of the highest-margin services, such as orthopedics or cardiovascular. But pulling that off can be a challenge because, first of all, it requires managing across departments and turfs.

The key to making it work is approaching it from a clinical, rather than solely a marketing, perspective, says Johnson.

This is not only important because researchers are discovering new sex differences in health issues every day, but also because physicians are more likely to be enthusiastic about a program based on innovative clinical approaches than one driven by marketing goals. One of the service line leaders' challenges is to make sure physicians are aware of the latest clinical developments in this area.

"You need to help them understand how programming can help not only their patients, but also help develop directed programs that can in fact build a broader base of patients," says Johnson.

One of the pitfalls many hospitals encounter when attempting to broaden the scope of women's health is the absence of physician leadership, she says. Starting and maintaining a cross-departmental program requires physicians involved in leadership, preferably partnered with an administrator.

"There are many places that we've talked to where the leadership has been purely administrative. If you're beginning to talk about integration across departments, you have to have strong administrative and physician leadership that not only understands the field, but can work with other chiefs or heads of other services effectively," she says. "That is so critical to the success of this service line. That leadership skill goes underappreciated in terms of what it means."

Generally, a women's health service line that extends beyond obstetrics should play to the organization's strengths. A hospital that is well-known for heart care and invested heavily in cardiovascular success may do well with a focused women's heart carve-out. The same wouldn't be true for every service line or for other hospitals where cardiovascular care isn't a strength. Women's health has to be expanded strategically, Johnson says.

"If you aren't strong in cardio care, it doesn't make sense to develop women's heart disease [care] because you don't have the bench strength. Making these programs not only based on science, but also making them synergistic with the institution is important."

Success Key No. 3: Make marketing interactive
Although women's health shouldn't be founded solely on marketing goals, they are still incredibly important to a program's success. Women are healthcare decision makers and often seek information about a hospital. Particularly before a childbirth, many patients take the time to research the technology, facilities, and physicians that will play a role in their care.

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