Women’s health needs more capital. But as clinics consolidate, the more urgent question is whether ownership models protect continuity of care, clinical autonomy, and the women who depend on both.
Recently saw this play out with our local health system and the largest insurance company in the state. Hundreds of thousands of people, many of them pregnant, fighting cancer, planning for surgeries etc, waiting to see if they would have to start over with a new clinic because theirs would be out of network. They did offer short term continuity for some conditions, but pregnancy wasn't one of them. Oh and in the middle of the enrollment period, so there's no option to move to a different insurer. It's obscene.
Not only have I seen this play out between a large insurer and a local ob/gyn practice group, that practice group later tried to force their choice of IUD on me. When I attempted to make my own selection, based on what they had placed earlier and fully covered by my insurance, they told me that they only stock one specific IUD and that if I wanted anything else, I would need to acquire it myself and bring it to them for placement. They suggested that I just order my desired IUD from my insurance company and "they had lots of patients who have done so" if they wanted a different IUD than the single brand/type stocked by the office.
Unsurprisingly, my insurance company was stunned and while they actually did an excellent job of trying to help me, it still required weeks of calls and messages with the insurer, the practice, and various pharmacies (and the pharmacies were likewise stunned).
It cannot be a coincidence that the practice group was sold from one private equity firm to another earlier that year.
Surgery drives corporate profitability (far better reimbursement than medical care), and OBG is more medical than surgical. But the really irony is that neonatal intensive care units (NICUs) are so profitable that they drive almost the entire financial ecosystem of children's hospitals, never mind highly successful emotional messaging to the contrary. Remarkably, few general health systems 'get' that connection, with none of the NICU downstream revenue, profit or even honorable mention going to the OBG doctors who bring in the mothers carrying those babies. Traditional health system finance silos see OBG and peds (which includes NICU) as separate, unrelated specialties and P&L tracks. Over 30 years dealing with health system CFOs, it always amazed me how the green eye shades continued to blink and act like those NICU babies arrived by stork...until they destroyed OBG departments and the NICU mysteriously emptied to competitors.
This is a great piece of analysis. In order to delve deeper, I would love to order a (digital) copy, but the link "Order a Copy" is an Amazon link. Is it possible to purchase a digital copy without buying it from Amazon?
Recently saw this play out with our local health system and the largest insurance company in the state. Hundreds of thousands of people, many of them pregnant, fighting cancer, planning for surgeries etc, waiting to see if they would have to start over with a new clinic because theirs would be out of network. They did offer short term continuity for some conditions, but pregnancy wasn't one of them. Oh and in the middle of the enrollment period, so there's no option to move to a different insurer. It's obscene.
Not only have I seen this play out between a large insurer and a local ob/gyn practice group, that practice group later tried to force their choice of IUD on me. When I attempted to make my own selection, based on what they had placed earlier and fully covered by my insurance, they told me that they only stock one specific IUD and that if I wanted anything else, I would need to acquire it myself and bring it to them for placement. They suggested that I just order my desired IUD from my insurance company and "they had lots of patients who have done so" if they wanted a different IUD than the single brand/type stocked by the office.
Unsurprisingly, my insurance company was stunned and while they actually did an excellent job of trying to help me, it still required weeks of calls and messages with the insurer, the practice, and various pharmacies (and the pharmacies were likewise stunned).
It cannot be a coincidence that the practice group was sold from one private equity firm to another earlier that year.
Surgery drives corporate profitability (far better reimbursement than medical care), and OBG is more medical than surgical. But the really irony is that neonatal intensive care units (NICUs) are so profitable that they drive almost the entire financial ecosystem of children's hospitals, never mind highly successful emotional messaging to the contrary. Remarkably, few general health systems 'get' that connection, with none of the NICU downstream revenue, profit or even honorable mention going to the OBG doctors who bring in the mothers carrying those babies. Traditional health system finance silos see OBG and peds (which includes NICU) as separate, unrelated specialties and P&L tracks. Over 30 years dealing with health system CFOs, it always amazed me how the green eye shades continued to blink and act like those NICU babies arrived by stork...until they destroyed OBG departments and the NICU mysteriously emptied to competitors.
This is a great piece of analysis. In order to delve deeper, I would love to order a (digital) copy, but the link "Order a Copy" is an Amazon link. Is it possible to purchase a digital copy without buying it from Amazon?