In all arrangements ranging from fee-for-service to global capitation, WIN obstetrics offers access to its clinically proven care management model. This unique system offers health plans the option of outsourcing all or part of their OB/GYN medical management. The WIN obstetrics Program includes pregnancy risk stratification, patient referral and triage, patient flow and tracking, maternity education program, medical management, prior-authorization, case management using WIN proprietary protocols, utilization management, outcomes management including subjective and objective measures, quality management and network management including formation of maternal-fetal-medicine (MFM) specialist-generalist care alliances and provider profiling. WIN provides claims management services under global capitation arrangements, expertly executed through customized systems and turn-key operations.

Collaborative involvement of WIN obstetric’s Medical Advisory Board in working with network physicians on a case by case basis provides the much needed physician-to-physician dynamic that is difficult for payor organizations to achieve. Treatment plans are discussed and the network physician is educated on current protocols and procedures. Each interaction is a positive educational experience, not an unpleasant encounter. The physician has an opportunity, normally not presented during day-to-day practice, to collaborate with a leader in the field of obstetrics and maternal fetal medicine. WIN’s maternal fetal medicine specialists provide timely consultations and may help redirect or support the primary physician’s treatment plan. As physicians are educated fewer inappropriate services are requested, as indicated below: