Despite increased attention over the past few years, we’ve seen little tangible movement when it comes to understanding and improving women’s health issues. At the center of this problem is a lack of strong and actionable data, whether that’s for developing and administering new medications or advancing care models specifically tailored to meet women’s needs.
Women are consistently underrepresented in clinical trials, especially in early-stage trials where they account for just 25% of participants in phases 1 and 2 combined. Additionally, federal research spending disproportionately targets diseases that mostly impact men. And even for conditions like Alzheimer’s Disease, where women account for two-thirds of all affected patients, just 12% of federal funding goes to studying the impact medications have on women’s health. Other diseases that affect women, such as fibroids and polycystic ovary syndrome, have had alarmingly minimal advancement in our clinical understanding of why and how these diseases develop and potentially effective treatments for them.
The problem doesn’t stop at the lack of funding and representation of women in clinical research; there’s a dearth of actionable data from the private industry, including insurers covering Medicare and Medicaid enrollees.
If we are going to move the needle on closing the gender health gap, we need to embrace a new framework for how we collect, analyze, and disseminate data across multiple sectors so that findings can be put into action. Health insurers are uniquely positioned to not only educate and empower women to seek proper medical care through promotional campaigns and product offerings, but they can also harness data to inform best practices across the entire healthcare industry.
Understanding the gender health gap and aligning incentives
Gender predicts disease risk, progression, and outcomes. Studies show that women are not only at higher risk of chronic disease but also of developing more complications. For instance, women with diabetes have a 58% greater chance of developing cardiovascular disease than men with diabetes. Women are also diagnosed later with six non-specific types of cancer. And women have a 20% higher chance of developing heart failure or dying within five years of their first heart attack than men.
Education and awareness campaigns that highlight various diseases are important parts of the puzzle. We’ve seen that populations act when health insurers promote healthy behaviors through educational and promotional materials, specifically campaigns that highlight the need for regular check-ups, and colonoscopies, or even campaigns that encourage women to talk to their doctors about concerns they have with issues like menopause and osteoporosis.
New entrants to the market like Elektra Health, Herself Health, HerMD, Midi, and Visana also create an opportunity for insurers to offer members additional services. These entities have spotlighted women’s health, offering new models of care that support women as they age.
However, incentives are not always aligned to significantly improve access, leaving women with limited options to get specialized care. Most payers still do not have a women’s health strategy, and among those that do, most only target maternity solutions. One significant reason for this gap is the absence of a complete dataset to begin to identify where the inequities exist. The need to disaggregate data by sex, and across ages, is critical. More informed and intentional data disaggregation will better identify needs and allow for better responses to gender inequities.
Since reimbursement for covered benefits is the only true way to improve quality, payers must think through products and services as rising risk evolves. Payers should enhance access to the essential and diverse health needs of women and measure outcomes. While all payers should think through women as a distinct cohort longitudinally, Medicare Advantage and Medicaid plans are uniquely positioned to take the lead given plan demographics — 56% of Medicare Advantage enrollees and 36% of Medicaid beneficiaries are women. Health problems often impact their ability to work, which then impacts income as they age, whether because of their health or because they become long-term caregivers.
7 strategies to build out
Creating more robust datasets and building targeted products won’t be easy. We’ve identified a roadmap that insurers can follow to support — and potentially grow — their female membership:
Offer unique benefits and services to ensure affordability and access. By gaining a better understanding of factors that drive inequality, like age, sexual orientation, poverty level, or geography, insurers can develop benefits that influence health outcomes within a population.
Offer supplemental benefits, including those that support social determinants of health. Insurers should emphasize access and financial literacy. These benefits should also look to improve activities that impact daily living, like physical and occupational therapy. And since women provide more caregiving than men, supplemental benefits should offer support for those types of activities.
Create a curated network designed to focus on women’s health. Provider networks should include clinicians who have high ratings, participate in patient sensitivity training, and who specialize in women’s health issues. Payers should think about partnering with providers and pharmacy benefit managers to elevate the role of women in the healthcare workforce in their communities.
Design education and awareness campaigns around the specific diseases. Among other things, target outreach on conditions that impact women differently as they age, including heart disease, mental health, and osteoporosis.
Develop formularies that support quality of life and improve symptoms associated with disease. A prime example is offering hormone replacement therapies and medications that alleviate symptoms of menopause.
Deploy a data and analytics platform designed to identify rising risks, and inequities, and measure outcomes. Insurers also need to support the training of more healthcare workers who often fall into these age and gender cohorts. Many payers do not have the necessary insights to create appropriate interventions and care coordination efforts.
Looking towards a brighter future
The industry has a great opportunity to close the gender health gap. With the data they already collect and reach into all parts of healthcare delivery, private insurers are uniquely positioned to work with other stakeholders to promote healthy behaviors, disease prevention, and data collection efforts so that inequities in healthcare can be properly addressed. Health insurers, particularly those that cover Medicare and Medicaid beneficiaries, need to take the first step of actively disseminating quantitative and qualitative findings to advance health outcomes and quality of life for all women.