title: The financial performance of labor and delivery units.
abstract: Hospitals and health care systems are already seeing the effect of health care reform with declining dollars. Hospital services, which had narrow financial margins in the past, will have further challenges. This article will review definitions, challenges, and potential financial solutions for labor and delivery units. Improving quality, efficiency, and cost requires substantial physician cooperation in the changing paradigm from physician-centric care to the transparent safety of teams. The financial contribution margin should increase the net revenue, but significant volumes are also needed. The challenge of this model for obstetrics is the slowing birth rate with the ultimate limitation for growth. Therefore, cost containment is imperative for sustainability. Standardization of hospital policies and procedures can improve quality and cost-savings with new incentive models. Examples include decreasing expensive pharmaceuticals, minimizing elective inductions of labor, and encouraging breast-feeding. As providers of health care to women, we all must engage in the triple aim of (1) improving the experience of care, (2) improving the health of populations, and (3) reducing per capita costs of health care. Although accountable care organizations presently are focused on Medicare populations for cost containment, all health care providers and institutions must be vigilant on both quality cost-effective care for sustainability, especially in obstetrics.
authors: Summa Akron City Hospital, Department of Obstetrics and Gynecology, Summa Health System Akron, OH.
authors: Vivian E
authors: VE
authors: von Gruenigen
authors: Diane M
authors: DM
authors: Powell
authors: Susan
authors: S
authors: Sorboro
authors: Michelle L
authors: ML
authors: McCarroll
authors: Unhee
authors: U
authors: Kim
mesh_terms: D060866:Accountable Care Organizations / Q000458:organization & administration; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000191:economics*; D007902:Length of Stay / Q000191:economics; D009775:Obstetrics and Gynecology Department, Hospital / Q000191:economics* / Q000458:organization & administration; D011247:Pregnancy; D058996:Quality Improvement / Q000458:organization & administration*; D014481:United States
keywords: accountable care organization; clinical integrated network; health care; obstetrics; quality