Care management and the ongoing need to focus on women’s health

Education for all genders is essential to improving women’s heart health

According to the Centers for Disease Control and Prevention (CDC), more than 60 million women – or 44% of those living in the U.S. – are living with some form of heart disease, and it accounts for approximately one in every five female deaths. 

In its 2024 report, “An Enterprise Approach to Health: Usage Insights from the Point of Care,” Wolters Kluwer Health focused on cardiovascular health research and trends based on clinical decision support (CDS) solution use. The Point of Care Report found that clinicians are increasingly seeking ways to enhance patient care and education around heart health for all patients, not just women, as evidenced by a notable 7% annual increase in usage of cardiovascular CDS topics.

Symptoms and risks of cardiovascular disease in many cases can be mitigated by implementing diet, exercise, and other behavioral modifications. There are also several comorbidities – like diabetes – and social risk factors – like food insecurity or tobacco use – that can exacerbate risk for all patients, not just women. Clinicians are well aware of these issues, but often don’t feel they are able to effectively intervene. Over time, research has shown that clinicians who are able to increase their office visits with patients from 6.7 minutes to 7.4 minutes were able to use that small time increase to notably amplify attention to health education and other concerns. Nonetheless, 27% of physicians still felt poor communication was contributing to patient mistrust.

Care management teams are well positioned to fill those gaps as part of a multi-prong approach to cardiac health. Combs notes that care management can help educate, not just women, but all members and patients on the signs and symptoms of heart disease and heart attacks in women.

“Women die because we don’t recognize that nausea and vomiting can sometimes be your first sign of a heart attack,” she explains. “Awareness is important and to understand that you can’t just look for symptoms based on what men experience, because it’s fundamentally different."

Prioritizing nutrition in women’s wellness programming

Women are “constantly bombarded with information on good nutrition,” Combs notes, although it tends to be related primarily if not exclusively to the needs of their children. “But there are a lot of women that sacrifice their needs in favor of their kids. And there are a lot of women that don’t have children at all,” she points out.

Women’s nutritional needs for optimal health differ from men’s and change throughout their lifecycles due to physiologic, neurologic, and hormonal distinctions. By personalizing educational outreach, care managers can help female members learn about proper nutritional support for their stage of life, separate from the broader needs of any family members or others for whom they feel a caretaking responsibility.

Cutting through the noise: How to engage female members in their health journey

Care management teams are already challenged to proactively engage health plan membership in health interactions, and there may not be a silver bullet that holds the secret to ramping up engagement of female members, Combs says.

She recommends reaching out to female plan members by “finding the things they’re already interested in” – whether that’s sports, the arts, hobbies, parenting, or caregiving for older relatives – and associating health and wellness education with activities in which women are already engaged.

“We can’t view women as a monoculture,” Combs notes. “There are women who live alone or don’t have children by choice. There are women who are primarily taking care of their families. And they’re all at different phases of their lives.  But the message is, whatever you want to do at your phase of life, make sure you stay healthy to do it. From a care management perspective, the best way for anyone to achieve that is to ask, ‘What are those small steps you can take to start building healthier habits?’ You don't ever want to reach out to someone and give them a laundry list of things to do.”

Combs also points out that a lot of care managers tend to be women, and that while the job can often be frustrating when reaching out to members proves difficult or futile, there is inherent opportunity in the potential to identify with female members and “being cognizant that they might be going through the same thing on the other side of the call with whatever you’re going through. It takes a lot of work and a lot of patience, but you have to keep the human in the center.”

The human side of member engagement

Just as care managers need to strive to “keep the human at the center” of their interactions, Combs says the solutions they use to engage members need to “have thought it through ahead of time” and present an experience that relates on as much of a personal and human level as possible to female members who may be frightened, frustrated, or hesitant to engage with care.

When care management teams use multimedia member engagement to amplify their impact, the quickest way to lose the loyalty and trust of female members is with “one of those videos that’s boring you to death because it's written in a purely medical or mechanical way,” says Combs. In her work with UpToDate® Member Engagement solutions, she has connected strongly with engagement content that “really talks with you as a human, not at you. We really try to identify with that person at the moment they are experiencing that condition or are in this stage.”

Among important considerations for engagement content, Combs lists:

• Varying gender representation within the content, so female-identifying patients and others can see themselves, their symptoms, and their practical day-to-day concerns depicted in the material.
• A variety of voices and narrations to represent different communities.
• Perspectives and options for members of varying abilities, cultures, and socio-economic realities so no one feels judged and it’s easier for members to absorb the information and make the right choices for themselves in partnership with their providers.

“You’re trying to meet them where they are and help identify with them so that they're more likely to be open to that health education, understand what situation they’re in and what they could do about it, and get back to the life that they want,” Combs says.

eBook: Care management’s role in establishing trust with members

Care management teams are uniquely positioned to advance women’s health and build, nurture, and cultivate trust and loyalty among female health plan members. Through their ability to make direct connections, teams can make an impact on overall member outcomes through enhanced interactions and personalized care experiences. Learn more in the eBook “Care management: Building trust through personalized member engagement.”