Getting to Yes Consumer Labor and Delivery Model

by Who Decides, What Matters | Series Topic 2 | Jul 31, 2026

Key Insights

After two decades of stalled advocacy, behavioral decision intelligence helped healthcare executives transform a high-risk capital proposal into an evidence-based Board decision.

Leadership replaced assumptions based on historical inference with evidence of future market behavior, advancing the proposal to secure approval
Historical utilization data showed past choices but provided no clear indication of whether families would switch hospitals - and locations - for a new care model.
The key question: would expectant mothers bypass an established suburban leader in favor of a new urban Women & Infants Tower?
A discrete choice experiment quantified likely switching behavior and the factors most likely to influence delivery decisions.
Predictive simulations estimated incremental deliveries, market-share gains, and financial performance across scenarios.

For more than two decades, a leading pediatric academic medical center’s Chief Medical Officer advocated for a Women & Infants Tower that would integrate labor and delivery with neonatal intensive care, pediatric subspecialists, maternal-fetal medicine, and enhanced patient amenities. The proposal repeatedly stalled because the Board required credible evidence that the tower would generate enough incremental deliveries to justify the hundreds of millions of dollars in construction costs.

Success hinged on whether expectant mothers would bypass the region’s established suburban labor and delivery leader in favor of an unbuilt urban facility. Historical utilization data reflected past choices, not future switching behavior in a market with no comparable facility.

The obstacle was not the vision but uncertainty.

Modeling a Market Before It Exists

MII designed a discrete choice experiment to simulate how families choose where to give birth. Women of childbearing age evaluated realistic delivery options that varied by affiliation, out-of-pocket costs, NICU capabilities, patient safety, room guarantee, family sleeping options, convenience, and patient satisfaction. Their choices indicated whether the proposed tower offered sufficient value to overcome the incumbent’s advantage.

These choices provided new data for decision-making. By simulating future scenarios, leadership could now estimate market share, incremental deliveries, and volume shifts across competing hospitals.

Replacing Assumptions with Decision-Ready Evidence

The simulations provided leaders with market scenarios for comparing against the project’s financial requirements. They also identified the factors most likely to motivate families to switch hospitals, helping executives assess the conditions needed for success. Behavioral decision intelligence turned a twenty-year discussion into a Board-level investment decision grounded in evidence.

The Strategic Value of Knowing What Matters Before Building

Major capital investments often stall when leaders cannot estimate demand in markets that do not yet exist. Behavioral decision intelligence shows where patients are likely to choose tomorrow—and what will influence those choices. For healthcare executives, that can turn a speculative capital debate into a disciplined investment decision.

In the next article in the series, Who Decides. What Matters, we will share what mattered to expectant mothers in Getting to Yes.

Mi4Sight® is Market Innovations, Inc.’s behavioral economics modeling solution. Built on more than 20 years of experience and 135 healthcare studies, it helps leaders test innovative hypotheses, quantify likely behavior, and evaluate investments before committing capital.

To learn more, visit Mi4Sight | Market Innovations Inc.

What Matters to Physicians When Capital Investment Depends on Future Physician Supply

In the recent Newsworthy article, "What Matters to Expectant Mothers: Turning Behavioral Evidence into Market Growth.", we presented findings that answer the question of what matters to consumers. Specifically, the article examined how expectant mothers choose where to deliver. The next question was whether the organization could recruit additional obstetricians to support the projected incremental volume.

The proposed center would combine the expertise of a world-class obstetrics service with full-spectrum pediatric subspecialty care. However, projected demand alone was insufficient to justify a major capital investment. Leadership needed evidence that they could attract enough obstetricians to support the business case—either through employment or voluntary alignment.

Rather than relying on historical recruitment patterns or stated intentions, which proved inadequate for predicting obstetricians’ interest in the new business model, MII designed two behavioral experiments to identify the drivers of obstetricians' decisions. The two physician segments we tested were: (1) physicians employed by the center and (2) physicians who had privileges at the center (and were aligned)

Forty-two obstetricians participated in the employment contract acceptance experiment, and 48 in the voluntary alignment agreement experiment. Twelve features were tested, with ten in the employment model and seven in the alignment model.

The results identified specific priority drivers for each physician segment/group

From What Matters to What Changes Behavior

The behavioral research went beyond identifying what physicians said they valued. It quantified how changes to the proposed offers could affect the likelihood of acceptance. Among the scenario simulations tested, the following illustrative results are presented for the employment contract and the voluntary alignment scenarios.

These findings gave leadership what historical data could not: a way to assess how specific investment and contract decisions might influence behavior before committing capital.

Connecting Demand, Physician Supply and Capital

The truly powerful insights are derived from integrating the two physician experiments with the earlier consumer research (What Matters to Expectant Mothers).

While the expectant-mother’s study identified what matters to families when choosing where to deliver and quantified the potential for incremental deliveries, the obstetrician's study identified what matters to physicians when deciding whether to work with or align with the organization and quantified how changes to the employment and alignment agreements could affect participation. Thus, both sides of the supply and demand economic/business equation were considered.

This changed the nature of the Board's decision. The proposed center was no longer supported solely by historical utilization, financial projections, or assumptions about physician participation. Leadership had behavioral evidence showing what mattered to the people who would determine whether the center could succeed—and how changes to the proposition could influence their decisions.

Learning extends beyond this center: when a major healthcare investment depends on changing future behavior, historical data can describe the past—but behavioral evidence can help leadership test the future before investing capital.

_________________________________________________________________________________

To learn more, visit Mi4sight | Market Innovations Inc.