title: The future of obstetrics/gynecology in 2020: a clearer vision: finding true north and the forces of change.
abstract: The pressure to transform health care has been building for many years, and many frameworks have been proposed for this transformation. The 'Triple Aim' concept of improving the health of the population, improving the experience of the patient, and controlling cost can be used as a guide post for the adoption of the necessary changes to thrive in a new construct of women's health care. Following these guiding principles should lead to improved clinical outcomes at affordable costs with high patient and provider satisfaction. The actual changes will come in the form of various 'transformational forces.' One of the driving forces will be conversion of the current payment structure from a fee-for-service model to value-based payments. In addition, the methods of care must be redesigned into a 'team-based' approach in which providers and patients use best practice protocols that are individualized to specific patient needs. Redesign will continue to drive consolidation of providers into larger groups to cover the cost of the needed infrastructure.
authors.affiliation: Memorial Care Health System and the Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of California, Irvine, Fountain Valley, CA.
authors.forename: David C
authors.initials: DC
authors.lastname: Lagrew
authors.affiliation: Department of Obstetrics and Gynecology, University of Alabama, Birmingham, Birmingham, AL.
authors.forename: Todd R
authors.initials: TR
authors.lastname: Jenkins
mesh_terms: D003695:Delivery of Health Care / Q000191:economics / Q000639:trends*; D018588:Fee-for-Service Plans / Q000191:economics / Q000639:trends; D005260:Female; D005544:Forecasting; D006176:Gynecology / Q000191:economics / Q000639:trends*; D018166:Health Care Reform / Q000191:economics / Q000639:trends; D006801:Humans; D009774:Obstetrics / Q000191:economics / Q000639:trends*; D010348:Patient Care Team / Q000191:economics / Q000639:trends; D058991:Patient Protection and Affordable Care Act / Q000191:economics; D018802:Patient-Centered Care / Q000191:economics / Q000639:trends; D011247:Pregnancy; D014481:United States; D016387:Women's Health