●  OB/GYN  ●

A stronger business behind your OB/GYN practice

OB/GYN carries some of the toughest economics in medicine: global maternity billing, brutal call schedules, high malpractice costs, and a payer mix you don’t fully control. The practices that thrive manage the business with the same rigor as the clinical work.

Sound Familiar?

Hard specialty, harder economics

Global billing leakage

Maternity globals hide revenue loss: missed visit documentation, unbilled non-global services, and transfers of care that never get reconciled against what was actually delivered.

Call burden without call math

Delivery call shapes recruiting, retention, and partner harmony — yet few groups have modeled what call actually costs and what fair compensation for it looks like.

The GYN schedule subsidizing OB

Office gynecology, procedures, and ancillaries are where margins live — but OB demands crowd the schedule and the investment attention.

●  Two Ways to Engage  ●

Same executive expertise. Two engagement models.

Both engagements bring senior healthcare-executive expertise to your OB/GYN practice. The difference is the number of hours per week your outside expert is involved — and who executes the plan.

Fractional Executive

We lead it with your team

A COO, CFO, or CEO-level operator embedded in your practice on a weekly cadence — running leadership meetings, working directly with your staff, and owning outcomes. Executive-caliber leadership at roughly 20–30% of the cost of a full-time hire.

Consulting

We build it, you run it

A focused engagement built around analysis and a clear, prioritized roadmap. Often the better value when you already have the leadership in place to execute a well-built plan — project-based, defined scope, defined deliverables.

How We Work

Five steps. Every engagement.

Every engagement — fractional or consulting, any specialty — follows the same five-step operating discipline.

1
Assess
2
Prioritize
3
Execute
4
Develop
5
Measure

Where We Focus

What we work on inside OB/GYN practices

Balancing the OB engine and the GYN margin — with the financial infrastructure this specialty’s complexity demands.

  Global maternity revenue integrity

Global-period tracking, non-global service capture, transfer-of-care reconciliation, and payer-specific billing rules — the leakage points closed systematically.

  Call & coverage economics

Call cost modeling, compensation structures for delivery coverage, and laborist/coverage alternatives evaluated on real numbers.

  Office GYN & procedures

In-office ultrasound, colposcopy, LEEP, and procedure scheduling — the high-margin schedule protected and grown alongside OB volume.

  APP & midwife leverage

CNM and NP integration for prenatal care, well-woman visits, and triage — scope, supervision, billing, and the capacity math behind it.

  Payer & contract strategy

Global rates benchmarked, delivery volumes leveraged in negotiation, and value-based maternity programs evaluated with eyes open.

  Partnership & growth planning

Partner compensation that survives OB/GYN’s uneven workloads, recruitment modeling, and expansion or affiliation decisions made from data.

“OB/GYN groups don’t fail from lack of patients. They wear down from economics nobody ever put on paper.”

Questions

Frequently asked questions

How can an OB/GYN practice improve profitability?
The reliable levers: close global-billing leakage (non-global services, transfer reconciliation), grow the office GYN and procedure schedule that carries the strongest margins, use CNMs and NPs to expand capacity, and benchmark payer contracts against your delivery volume. Most groups find meaningful revenue inside services already delivered but never fully captured.
What is global maternity billing leakage and how do we stop it?
The global fee covers routine prenatal, delivery, and postpartum care - but visits beyond the routine number, problem visits, ultrasounds, and many services are separately billable, and patients who transfer in or out require itemized reconciliation. Practices without systematic global-period tracking routinely leave 5-10% of maternity revenue uncollected. The fix is workflow: track every OB episode against payer rules from registration to postpartum close-out.
Should our group add certified nurse midwives?
CNMs can expand prenatal and delivery capacity, improve patient experience, and ease physician call burden - if the model is built deliberately: state scope and supervision rules, hospital privileges, billing (including incident-to and split-visit rules), malpractice, and clear escalation protocols. We build the financial and operational model so the decision is made on numbers, not hope.
Can you help with call schedule and partner compensation disputes?
Yes - these are two of the most common flashpoints in OB/GYN groups, and they're usually data problems disguised as fairness problems. We model what call actually costs, benchmark compensation structures, and design productivity and call-pay methodologies with transparent monthly reporting - so the partnership argues about strategy, not arithmetic.
●  FROM THE ARCHIVE  ●

The OB/GYN briefing series

Five sourced, data-driven reports on the business of running an OB/GYN practice.

01
Ancillary Lines in OB/GYN: Ultrasound, Laboratory, and Elective Wellness

OB/GYN ancillary revenue: what in-office ultrasound, genetic lab services, and elective wellness lines actually earn.

02
Call Coverage, Staffing Models, and the Economics of Physician Burnout

OB/GYN call coverage economics: hospitalist models, nocturnist arrangements, and what the math looks like when a burned-out partner quietly reduces their.

03
Global Obstetric Billing and Where the Revenue Leaks

Global obstetric billing explained: how the CPT 59400 and 59510 package works, where antepartum documentation gaps cost you money, and what to audit first.

04
Managing Professional Liability Cost in an Obstetric Practice

OB/GYN malpractice insurance costs: 2025 Medical Liability Monitor data, why obstetric premiums vary by state.

05
Migrating Gynecologic Procedures to the Office and Building the Service Line

Office-based gynecologic procedures: which procedures migrate well, what the billing and facility-fee economics look like.

Book your complimentary discovery call now

Thirty minutes. No pitch. An honest read on where your practice stands.

Free Consultation

(844) 451-0524