Population changes and disease prevalence

– Labor and delivery volumes continue to decline as people have fewer children

+ Growth in people delivering at older ages and disease prevalence increases complex deliveries, despite overall decline in fertility rate

– Declines in total births equate to fewer outpatient obstetrics visits

+ Growth in people delivering at older ages and in disease prevalence increases need for complex perinatal care, despite decline in fertility rate

Technology adoption

– Continued adoption of minimally invasive techniques shifts care to outpatient settings

+ Continued adoption of minimally invasive techniques shifts care to outpatient settings

– Telehealth has enabled more care to shift home, reducing in-person volumes

Insurance changes

– Push by payers to decrease more costly inpatient procedures

– Growth in uninsured and Medicaid population will lower utilization

Care management

– Increased push by stakeholders to decrease C-sections lowers length of stay

– Changes in access to legal abortion care reduces utilization of related abortion and miscarriage care

– Changes in access to legal abortion care reduces utilization of related abortion and miscarriage care