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Women receive health care that is below par, and the consequences are unnecessary morbidity and death. It is fact, not fiction—borne out by significant data that reveal disparities across many major conditions—that inattention to women’s unique symptoms, risk factors, disease biology and treatment effects are causing harm to women. Despite the reality, a poor body of research exists to point women’s health in the right direction.
Value-Based Health Care (VBHC) assumes that we can measure providers’ delivery of health care against clinical standards. What if we don’t even know how half the population exhibits disease or responds to therapies? At the least, VBHC will reward providers for the wrong things.
For example, if we don’t understand that heart failure prognosis and treatment is different in women versus men—which stems from underrepresentation of women in clinical trials for the disease—practices can generate different costs and outcomes based on their patient populations, alone. Our VBHC incentives will do nothing to further the quality nor the improvement arc of outcomes and cost without understanding what interventions work in subpopulations.
For health systems and ACOs to help their providers adhere to a standard of care and to use population health effectively, they need protocols based on accurate research…