Healthcare News of Note: What can be done to correct data disparities in women’s health?

• The prevalence of women’s health conditions is roughly five times that of their documented diagnoses, which means for every woman diagnosed with a women’s health condition, roughly four go undiagnosed.
• The 2023 emergency medicine Match will see 555 initially unmatched positions, affecting a larger number of residency programs than in 2022, when 219 unmatched positions affected one in four programs.
• The vast majority of physicians responding to an American Medical Association survey reported prior authorization requirements led to higher overall utilization of healthcare resources, resulting in unnecessary waste rather than cost savings.

Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.    

1. Data disparities in women’s health are influencing health outcomes

“Blind spots in the insights that drive research design, investment decisions and pipeline priorities” are being driven by data disparities in women’s health and “ultimately influence health outcomes for women globally,” according to an April 3 online article by McKinsey & Co.

“Gaps [in women’s health] span the entire data value chain — from defining women’s health (pre–data generation) to diagnosing (data generation) to tracking at the national level (data collection) to translating data into insights at the global level through epidemiological studies (data analysis).”

What does this mean for women’s health?

According to the article, “the prevalence of women’s health conditions (estimated by epidemiological data sources) is roughly five times that of their documented diagnoses,” based on U.S. claims data from January 2019 through August 2022.

“In other words, for every one woman diagnosed with a women’s health condition, roughly four go undiagnosed. In comparison, the difference between epidemiological prevalence and documented diagnoses for men’s health conditions narrows to roughly 1.5 times,” wrote the authors.

Key findings

The article reviews all the above-stated gaps in detail, but here we provide two takeaways:

• Women represent approximately 40% of primary care physicians (PCPs) but comprise nearly 50% of PCPs documenting diagnoses of menopause, polycystic ovary syndrome (PCOS) and endometriosis.
• Medical training lacks focus on women’s health issues, as a 2016 national study of 112 internal-medicine residency programs published in the Journal of Women’s Health revealed. The study showed 25% of programs did not include menopause in the core curriculum, 30% did not include contraception, nearly 40% did not include PCOS and more than 70% did not include infertility.

What’s to be done?

Three of the article’s five recommended steps to close the data gaps in women’s health are:

1. Acknowledge the importance of a person’s sex in the definition and treatment of disease.
2. Reinforce incentives at every step of the data value chain for women’s health.
3. Improve the generation and use of data in care delivery.

2. EM Match sees shortfall in candidates for second year in a row

The 2023 emergency medicine (EM) Match will see 555 initially unmatched positions, affecting a larger number of residency programs than in past years, according to a joint statement released March 13 by 11 organizations.

The latest shortfall comes on the heels of the 2022 EM Match, which saw “an unprecedented initial 219 unmatched positions affecting one in four residency programs,” according to the statement.

“There are multiple factors leading applicants to favor other specialties over EM,” including but not limited to:

• Workforce projections
• Increased clinical demands
• Emergency department (ED) boarding
• Economic challenges
• Impact of the COVID-19 pandemic

HFMA insight

“HFMA executive members are acknowledging that the decline in EM matching is a complex issue, particularly as we emerge from the pandemic. The demanding nature of EM, characterized by long work hours, high-stress environments and intense competition, has deterred candidates from pursuing the specialty,” said HFMA’s Shawn Stack, director of perspectives & analysis.

“Moreover, the pandemic has further affected medical education and training, reducing clinical rotations and exposure to EM for some students,” Stack added. “Additionally, younger generations are prioritizing better work-life balance, which historically has not been well-supported by the demands of EM. The factors mentioned above have created a complex challenge for EM matching, and healthcare leadership is directing their efforts towards addressing these issues to improve engagement in the field.”

Match task force assembled

“To better understand these factors and define a path forward, a Match Task Force has been convened with broad EM organizational representation,” wrote the statement authors. “The Task Force is working to identify factors that have led to an increase in unfilled EM positions and to develop strategies to mitigate them.”

Among the organizations releasing the statement are American Academy of Emergency Medicine, American College of Emergency Physicians, Association of Academic Chairs of Emergency Medicine, Clerkship Directors in Emergency Medicine and the Emergency Medicine Residents’ Association.

3. AMA survey: Physicians say prior authorizations lead to higher overall use of healthcare resources

Most physicians (86%) indicated prior authorization requirements led to higher overall utilization of healthcare resources, resulting in unnecessary waste rather than cost savings, according to a March 13 news release based on the results of an American Medical Association (AMA) survey.

“More specifically, about two-thirds of physicians reported resources were diverted to ineffective initial treatments (64%) or additional office visits (62%) due to prior authorization policies, while almost half of physicians (46%) reported prior authorization policies led to urgent or emergency care for patients,” according to the release.

Other findings

Just two of the additional findings from the survey are:

• 33% of physicians reported that prior authorization led to a serious adverse event for a patient in their care, including hospitalization, permanent disability or death.
• 89% reported that prior authorization had a negative impact on patient clinical outcomes.

“The AMA continues to work on every front to streamline prior authorization,” wrote the authors. “Through our Recovery Plan for America’s Physicians the AMA is working to right-size prior authorization programs so that physicians can focus on patients rather than paperwork.”

HFMA bonus content

• Download the latest HFMA Principles and Practices Board white paper, “Assessing Reality in Healthcare Financial Information.”
• Read “Medicare’s proposed FY24 update to inpatient payments falls short, hospitals say,” by Nick Hut, HFMA senior editor.
• Listen to the first installment of a three-part series on the healthcare workforce in the latest Voices in Healthcare podcast episode, with host Erika Grotto. In this episode, Jonathan Wiik of FinThrive and Todd Nelson of HFMA discuss burnout among nonclinical workers and how remote work is changing hiring.