There’s a disconnect in communication between providers and female consumers. Too often, providers unknowingly assume what female consumers want and need based on incomplete or inaccurate scientific knowledge. Enhancing health literacy for consumers and providers is the first step to minimizing outcome disparities for women.

Key stakeholder actions:
 

• Consumers: Join virtual and in-person support groups. Take the initiative to educate yourself about your conditions and symptoms from credible resources like the CDC or a trusted provider.
  
  
• Digital health companies: Consider ways where you can leverage your customer base to raise awareness on women’s health needs, such as:
  • Diversity and accurate representation in data used to train machine learning as AI becomes increasingly integrated into tools for clinicians.
  • Use of artificial intelligence (AI) to seamlessly connect users to customized educational resources and local providers for overlooked women’s health conditions like autoimmune diseases and osteoporosis.
  • Marketing and social media campaigns to reduce the stigma associated with women’s health conditions and experiences like menopause, sexual health, and pelvic health.
  • Employer benefit solutions supplemented with wearables and apps that help women monitor biometrics (e.g., sleep, heart rate, menstrual cycle, physical activity) and generate personalized resources in relation to their health and fitness goals.
• Frontline providers: Recognize your own biases and your engagement in a system which has led to the status quo. Remove psychological barriers to seeking and receiving care by asking women what they need to feel:
  • Comfortable seeking care.
  • Informed about their risk factors, health status, and treatment options.
  • Listened to, respected, and understood.
  • Free from discrimination and stigma.
• Health plans:
  • Use digital navigation and member engagement tools to recommend care or next steps to patients.
  • Incorporate women’s health into patient education tools and ensure that topics span the breadth of women’s health — not just reproduction.
• Life sciences companies: Leverage medical affairs teams to increase physician and market awareness of women’s health conditions by aggregating diagnostic and treatment information for commonly misunderstood and underdiagnosed conditions like menopause or polycystic ovary syndrome.
  
  
• Provider organizations: Identify opportunities to improve clinician education and training on women’s health needs, such as:
  • Ongoing clinician training to identify and assess conditions that affect most women, conditions that present differently in women than in men, and conditions that pose greater risks (including complications) to women than men.
  • Team-based primary care programs that facilitate collaboration across specialties to ensure women’s needs are addressed across the lifespan, not just during pregnancy.

The United States spends more on healthcare than any other high-income nation, yet it has the worst health outcomes of that group, especially among women. Reducing health disparities among women not only improves the nation’s health status but also offers economic benefits resulting from reduced medical costs and improved productivity. Health outcomes are shaped by the interplay of socioeconomic factors, so interventions should aim to reduce disparities.

Key stakeholder actions:

• Digital health companies: When designing tools, create solutions that can improve care access for women with varied digital literacy levels, access to internet coverage, and abilities.
  
  
• Employers: Equip employees with information on women’s health, including information on high-quality providers and healthcare systems.
  
  
• Self-insured employers: Analyze your own health outcomes and claims data to identify areas that need improvement. Consider working with your health plan to analyze the data and determine actionable strategies.
  
  
• Health plans: Collect member data and stratify outcomes and treatment by race, ethnicity, gender, age, and preferred language (REGAL) data at a minimum. Use the data to:
  • Assess women’s health inequities and establish quantifiable goals to address those inequities.
  • Share information with other stakeholders in an accessible, usable, and actionable format.
• Provider organizations: Guarantee that processes are in place to:
  • Expand access to women’s care using telehealth modalities such as virtual visits and remote patient monitoring for maternal healthcare. Conduct digital needs assessments to make sure telehealth programs don’t exacerbate digital inequities.
  • Embed evidence-based standards into frontline care for women. The data-driven maternal safety bundles for hospitals and health systems from the Alliance for Innovation on Maternal Health (AIM) are examples of available evidence-based standards.
  • Implement ongoing feedback mechanisms to monitor adherence to care standards and identify other gaps in women’s care.
  • Offer frontline staff ongoing cultural humility and clinical training that addresses how injustice manifests in healthcare. Also, dispel misconceptions about women’s health that lead to disparate care.

The U.S. healthcare system tends not to incentivize services that cater to the unique needs of women, other than physician-led fertility treatments and childbirth. Services for uterine fibroids and pelvic floor disorders, for example, are underserviced despite the demand for care. Incentivizing professionals and programs in underserviced fields would help meet growing demand, reduce healthcare costs, and increase productivity.

Key stakeholder actions:
 

• Employers:
  • Expand benefit offerings for women outside pregnancy and fertility, such as expanded coverage of menopause symptom treatment and improved caregiving benefits.
  • Consider contracting with digital platforms like Midi and Gennev to expand offerings for menopause care. Push potential partners on how they can help you recruit and retain an engaged and supported workforce.
• Government and lobbying groups:
  • Expand Medicaid reimbursement policies for poorly reimbursed women’s services such as reproductive health services.
  • Increase national research funding and surveillance of diseases predominately experienced by women, such as endometriosis and rheumatoid arthritis.
  • Professional organizations like the American Hospital Association can help call attention to and endorse the actions of provider organizations. They can also apply pressure to lobby for regulatory changes that could result in actionable changes for their provider members.
• Health plans:
  • Incentivize a multidisciplinary, continuity-of-care approach to women’s healthcare delivery using bundled payment strategies.
  • Incorporate quality measures into value-based care contracts for care of conditions predominately experienced by women, such as menopause and autoimmune diseases.
  • Establish partnerships with developers of medications and monitoring devices that treat underserved women’s health conditions to help defray costs.
• Provider organizations:
  • Medical schools can offer scholarships or tuition reimbursement for students who agree to go into high-demand fields like urogynecology and maternal-fetal medicine.
  • Other provider organizations may consider opportunities to incentivize high-demand specialties (e.g., primary care) and subspecialties with unmet needs (e.g., reproductive endocrinology, bariatric care, etc.). Organizations can:
    • Adapt physician compensation models to include metrics that promote collaboration, like the number of shared patients.
    • Create shared-staffing models that include multidisciplinary teams of physicians, nurses, and allied health staff to increase the capacity of specialists.
    • Implement scholarships and residency programs for women’s specialties with high unmet need. Incentivize training sessions like the North American Menopause Society’s Certified Menopause Practitioner program.
    • Establish creative partnerships (e.g., remote consultations) with neighboring facilities to split the cost of specialists if facing recruitment challenges.

Limited scientific understanding of the causal relationships and biological underpinnings for many conditions that adversely affect women inhibits the range and efficacy of treatment options. These conditions include endometriosis, uterine fibroids, autoimmune diseases, and even heart disease. Only 1% of roughly $200 billion spent on healthcare research and development in the United States focuses on non-oncologic conditions that predominately affect women. Because clinical studies have been historically conducted on men, disease presentation and appropriate treatments are not well understood in women. For example, dosing thresholds for common pharmaceuticals like chemotherapy and antidepressants are often too high for women, leading to more side effects and adverse events in women than in men.

Key stakeholder actions:
 

• Device companies: Guarantee adequate representation of women in the design and development of medical devices.
  
  
• Digital health companies: Establish better tools to track health metrics and prevent or limit the risk of serious complications among women, especially women of color.
  
  
• Life sciences companies:
  • Prioritize research on diagnostic tools, treatments, and chronic disease prevention approaches specific to women.
  • Include women, particularly women of color in more clinical and pharmaceutical research to bridge the knowledge gap created by historical exclusion from studies.
  • Consider integrating alternative sources of evidence (like real-world evidence) and alternative clinical trial designs to reach these populations.
• Provider organizations:
  • Partner with life sciences companies to advance clinical research on conditions with limited scientific understanding that predominately impact women.
  • Collect real-world evidence through analysis of health records or remote patient monitoring device data to identify women’s reactions to treatments that may need lower dosing.
  • Hold your supplier and pharmaceutical partners accountable by asking how their products and services have been designed for and tested on women.

Women’s health is more than just the presence or absence of disease. Efforts to advance women’s health must go beyond treating existing conditions. Investing in preventive care — and an infrastructure to support a woman’s whole health — can lead to monumental savings in long-term healthcare expenditures.

Key stakeholder actions:

• Digital health companies: Evaluate opportunities to meet women’s social needs, such as embedding pathways in digital platforms to connect women and their families to resources for housing, food, and transportation services in their local area.
  
  
• Employers: Foster a culture of well-being through expanded coverage of health services, flexible scheduling, and work locations. Offer resources to provide support for an array of needs, such as financial counseling and nutritional assistance.
  
  
• Government and lobbying groups:
  • Enact policies to improve access to affordable nutritious foods, transportation options, and childcare services.
  • Fill gaps in health insurance coverage by expanding eligibility criteria for Medicaid beneficiaries who are not pregnant.
• Health plans: Advance providers' adoption of Z-codes by reimbursing screenings for social determinants of health (SDOH) and social service navigation.
  
  
• Provider organizations:
  • Use Z-codes to identify and flag women with social needs for follow-up with social workers or community health workers who can connect them to community-based organizations and social services.
  • Emphasize well-being — including mental, emotional, social, and financial health — by cultivating cultural humility and trauma-informed care among clinicians.
  • Facilitate partnerships between women’s specialty care leaders and system-wide leaders of population health or health equity initiatives to expand initiatives that address the root causes of inequity in social determinants of health.