Major structural changes are under way in the delivery of women’s health care by Rhode Island’s two largest hospital systems, Care New England and Lifespan.

These changes, which hospital officials claim are primarily designed to put women’s health needs first, offer a lens into the new business models being adopted by the two hospital systems as they struggle with declining revenue.

In the brave new world of health care reform, hospitals and doctors are seeking to wean themselves from fee-for-service delivery systems to those organized around metrics that benchmark health outcomes and wellness, a change that will yield increased future payments and rewards.

Likewise, investments in outpatient medical centers as hospitals reinvent themselves into accountable-care organizations offer a more holistic approach to health and prevention – as well as a path toward improving the future rate of return for hospitals.

Women’s health services in Rhode Island have become a proving ground for the new approaches – and along with the changes come opportunities and risks for greater competition and collaboration, for both patients and providers.

In September 2011, Lifespan launched the Women’s Medicine Collaborative, an outpatient medical center with all its services under one roof, focused on personalized, comprehensive caring for women at all stages of life. Located near the main U.S. Post Office in Providence on West River Street in a newly rehabbed, former mill building, the collaborative’s trademarked brand of “For women. By women,” underscores that all care there is provided by women, across multiple disciplines and specialties, including behavioral health.

Dr. Karen Rosene Montella, who serves as Lifespan’s senior vice president for women’s care and clinical integration, is one of the medical center’s founders. Until February 2011, she had served as chief of medicine at Women & Infants Hospital.

“We recognize that women have very unique and specific health care needs,” Rosene Montella said at the time of the launch. “So we were excited to pull together these specialties under one roof to provide women with the best care possible. This fits Lifespan’s strategic vision to provide our patients with an optimal care experience that is unique to Rhode Island.”