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How Should We Transform the Delivery of Women’s Health?

Digital health technologies have received record investment over the past decade but as a recent report from TT Capital Partners points out, the women’s health market has noticeably lagged behind other sectors in healthcare. It is ripe for innovation because of the “the sheer scale of the space, its rapid growth and the fact that its acute pain points are at odds with the relatively low level of historical investment and innovation we’ve seen in the marketplace.”

Today, forecasters estimate the market opportunity for women’s health will exceed $60 billion by the year 2027. Women’s health is no longer considered a niche. At the same time, a new study from the CDC found that more than 80 percent of pregnancy-related deaths are preventable. Access to maternal care has decreased in the last year, according to March of Dimes. And Black women are still dying from pregnancy-related complications at 3-4x the rate of White women. There’s a lot of opportunity to transform the delivery of care for women in this country but there’s also a lot at stake.

Where do we start? 

The overall challenge we face in women’s health today is straightforward, at least when it comes to the diagnosis. Patients aren’t consistently empowered to do what they need to do. Providers are not equipped to do what they want to do.

We all know this to be true. Patients are overwhelmed and confused by a system that’s hard to navigate and often lack the access or ability to actively participate in their care. Meanwhile providers are burned out, stretched thin and lack time, data and tools required to deliver the very best care.

As a result, when you look at all the major levers we have at our disposal, such as physician visits, diagnostic tests. prescriptions and lifestyle changes, there are gaps across the board that result in quality that’s too low and costs that are too high.

There are two main disconnects that create these undesired outcomes. One is the delta between the provider’s care plan and what the patient does. The other is the delta between evidence-based standards and the provider’s care plan. Let’s pause for a moment. I’m not suggesting that patients don’t generally want to do the right thing, or that patients lack the desire to actively participate in their care. I’m also not implying that clinicians are not using evidence-based medicine to care for their patients. What I am saying is that a barrage of obstacles are hindering the best of intentions from both patients and providers.

On the patient side of the equation, there are multiple issues that impede adherence to care plans and healthy decisions. Social, economic and behavioral factors play a major role. A patient’s biology and genetics, as well as physical environment, also dramatically impact health outcomes. All these drivers need to be considered as we identify how to more effectively engage patients in care.

Meanwhile, for providers, there are challenges with communication, diagnosis and follow up with patients. In many cases, clinicians lack access to data, key tools and appropriate time and resources to deliver care the way they want.  As if all of this wasn’t enough, there are also systemic issues preventing success. Access to care can be a real barrier for many patients. The current system also creates real challenges for coordination of care. To top it off, fee-for-service payment models create misaligned incentives and missed opportunities to fuel positive outcomes.

So, what do we do about all of this? 

At the beginning of this article, I said the diagnosis of the problem is straightforward. The response is not quite as simple. But there is a clear path for solving it. We need true transformation in women’s health, both in the way we deliver care and how we pay for it.

When it comes to transforming care delivery, we must create personalized experiences for patients. We must improve health literacy and educate patients on how to be active participants in their health. We must make sure women are aware of the resources they have available through their health plan, health system and local community. We must leverage technology to create 24/7 support. We need to expand access to care, particularly in areas that have been defined as maternity care deserts. Using telehealth networks of specialty services is one strategy that can make a big difference.

On the provider side of the equation, we must get better at monitoring patients and notifying clinicians when there is an urgent need. We must increase timely access to actionable data, and we have to find ways to relieve some of the burden of patient activation and adherence so that clinicians can focus on caring for the patients they see every day. We also must make it a priority to deeply integrate the resources that are available through payers and providers so that patients can easily navigate and receive the care they need.

In terms of payment models, we must implement new funding mechanisms that share value and reward healthy outcomes. Value-based care can be complicated, and it requires thoughtful discussion and design. Value-based care is also the only way we will appropriately finance and fuel meaningful improvement in maternal health outcomes in this country. In the end, value-based care is more than worth the effort. In fact, I would argue it is the only way forward.

We are approaching a new era for women’s health. This new era will usher in true transformation in both the delivery of care and the financial models that underpin it. This evolution will not be painless, but it is absolutely potent and one thousand percent necessary. Both payers and providers will have to respond strategically to this shift. Entrepreneurs and innovators will have to step up their game to meet the new demands that come with this transformation. It will require a significant commitment and unprecedented partnerships.

But this is a journey that we must take if we want to generate better outcomes for women and babies and families. And the best part?  If we are successful, everyone benefits. We will produce healthier moms and babies, alongside healthier bottom lines for both payers and providers. Higher quality, lower costs. And a better experience for all stakeholders. This is a future that is fully within reach, if we reach for it together.

Photo: FotografiaBasica, Getty Images

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