Digital health technology has received record investment over the past decade, but as a recent report from TT Capital Partners points out, the women’s health market lags significantly behind other healthcare sectors. It’s ripe for innovation because of “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 market.”
Today, forecasters believe that the market opportunity for women’s health will exceed 60 billion dollars by 2027. Women’s health is no longer considered a niche. Meanwhile, a new CDC study found that more than 80 percent of pregnancy-related deaths are preventable. Access to maternity care has declined over the past year, according to the March of Dimes. And black women still die from pregnancy-related complications at 3-4 times the rate of white women. There is much opportunity to transform the delivery of care for women in this country, but there is also much at stake.
Where do we start?
The overall challenge we face in women’s health today is simple, at least when it comes to diagnosis. Patients are not consistently empowered to do what they need to do. Suppliers are not equipped to do what they want.
We all know this to be true. Patients are overwhelmed and confused by a system that is difficult to navigate and often lack access or opportunity to actively participate in their care. Meanwhile, providers are exhausted, drained, and lacking the time, data, and tools needed to deliver the best care.
As a result, when you look at all the basic levers that we have at our disposal, like doctor visits, diagnostic tests. prescriptions and lifestyle changes, there are gaps everywhere that lead to too low quality and too high costs.
There are two main interruptions that create these unwanted results. One is the delta between the provider’s care plan and what the patient does. The other is the difference between evidence-based standards and the provider’s plan of care. Let’s pause for a moment. I am not suggesting that patients generally do not want to do the right thing, or that patients are unwilling to be actively involved in their care. I am also not implying that clinicians do not use evidence-based medicine to care for their patients. What I am saying is that multiple obstacles stand in the way of the best intentions of both patients and providers.
On the patient side of the equation, there are numerous issues that hinder adherence to care plans and health decisions. Social, economic and behavioral factors play a major role. A patient’s biology and genetics, as well as the physical environment, also dramatically affect health outcomes. All of these drivers must be considered as we identify how to more effectively engage patients in care.
Meanwhile, there are challenges for providers with communication, diagnosis and patient follow-up. In many cases, clinicians lack access to data, key tools, and the appropriate time and resources to deliver care the way they want. As if all that wasn’t enough, there are also systemic issues that stand in the way of success. Access to care can be a real barrier for many patients. The current system also creates real challenges for care coordination. On top of that, fee-for-service payment models create misaligned incentives and missed opportunities to drive positive outcomes.
So what to do with all this?
At the beginning of this article, I said that diagnosing the problem is easy. The answer is not so simple. But there is a clear way to solve it. We need a real transformation in women’s health, both in the way we deliver care and the way we pay for it.
When it comes to transforming care delivery, we need to create personalized experiences for patients. We need to improve health literacy and educate patients on how to take an active role in their health. We need to make sure women are aware of the resources available to them through their health plan, health system and local community. We need to use technology to create 24/7 support. We need to expand access to care, especially in areas that have been designated as maternity care deserts. Using specialty telehealth networks is one strategy that can make a big difference.
On the provider side of the equation, we need to get better at monitoring patients and notifying clinicians when there is an urgent need. We need to increase timely access to actionable data, and we need 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 must also make it a priority to deeply integrate the resources that are available through payers and providers so that patients can easily navigate and get the care they need.
In terms of payment models, we need to implement new funding mechanisms that share value and reward healthy outcomes. Value-based care can be complex and requires thoughtful discussion and design. Value-based care is also the only way we will adequately fund and nurture meaningful improvement in maternal health outcomes in this country. Ultimately, value-based care is more than worth the effort. In fact, I’d say it’s the only way forward.
We are approaching a new era for women’s health. This new era will usher in a real transformation in both the delivery of care and the financial models that support it. This evolution will not be painless, but it is absolutely powerful and one thousand percent necessary. Both payers and providers will need to respond strategically to this change. Entrepreneurs and innovators will need to step up their game to meet the new demands that come with this transformation. This will require significant commitment and unprecedented partnerships.
But it is a path we must take if we are to generate better outcomes for women, babies and families. And the best part? If we succeed, everyone wins. We will produce healthier mothers and babies, along with healthier outcomes for both payers and providers. Higher quality, lower costs. And a better experience for all stakeholders. It is a future that is entirely achievable if we strive for it together.
Photo: FotografiaBasica, Getty Images