Women have historically been the caretakers of family and community. But often the efforts they put forth taking care of others means they don’t take care of themselves. The Kaiser Family Foundation reported in 2021 that 10% of women with a chronic condition don’t have a primary-care provider. And among those who visited a doctor in the previous two years, women are more likely than men to say a health care provider dismissed their concerns or didn't believe they were telling the truth. 

At a recent From Day One webinar, titled “How Women’s Health Benefits Can Address Barriers to Care,” leaders from Accolade, a personalized health navigation and advocacy platform, discussed why it’s vital to ensure women have access to needed care–and not just related to reproductive health, although that is often women’s entry point women into more complex aspects of the health care system, said Jessica Huertas, clinical steward of Accolade’s Women’s Health Team.

In the last decade, questions from Accolade members, as well as the support they require, have changed. The pandemic led to an uptick in behavioral and mental health needs, Huertas said. More recently, there have been increasing questions from families struggling with the choice to carry a pregnancy to term or not, regardless of the reason. Huertas and her team help find safe reproductive care and advice, as well as access care if they can’t obtain it locally. 

Accolade fields questions about parental leave, breast pump coverage, and how to add a baby to one’s health care plan after delivery. “They want to know their return-to-work childcare options, and if their company offers dependent care savings plans or college savings resources,” Huertas said. “They have questions about what a pregnancy and childbirth will cost them after insurance pays its portion, or what fertility treatment will cost so they can plan for it. And they want that information ahead of time.”

Beyond Parenthood

Since working women are the primary caretakers of a community that often extends beyond their immediate family—three quarters of caretakers are women who work at least 30 hours a week—Mary Lasky, director of benefits at Accolade, said they started examining how to best take care of the caretakers. “There is pressure on those women caregivers that impacts their health as well as their work.” 

Accolade has made changes for its employees to address these issues, including: 

•A sick and safe leave policy, alongside of their existing time away policy, that allows caregivers protected time away when they’re faced with urgent issues;

•A partnership with Cariloop, a caregiving-support benefit that can help users find resources for eldercare or other caregiving needs, and also help them understand their own future Medicare journey;

•A family-forming benefit through Carrot, a fertility benefits platform;

•A $2,000 health-reimbursement account.

There can be pushback from some about any new emphasis put on women’s health, but Lasky has an easy retort: “Improved health care for women is improved health care for their families, for their communities, and on down the line. In our company, 75% of our employees identify as female, and if we improve the health of that population, we create a domino effect. Those healthy individuals are interacting with our customers and our clients and our members and helping them live their healthiest lives. This is an intricate web and impacting one can impact the whole.”

Besides, Huertas noted, even if the majority of your employees are men, they often have spouses and daughters whose care comes from the benefits you offer. 

Non-binary populations have also been getting more attention–rightly so, says Lasky. “I think companies are behind the times on this issue.” The systems and vendors that support employees need to support non-binary or female-identifying employees upon hire or enrollment. “A year or two ago, I was working with a vendor that couldn’t accept anything in their file integration feed, other than M or F for gender. That is an issue.”

Half of the LGBTQ population reports some sort of health care discrimination, and almost 20% of Gen Z identifies as LGBTQ, Lasky noted. “This has to change if we want to integrate the new generation into our companies and benefits. We should have started thinking about it five years ago.”

Lasky added that Carrot offers help to the LGBTQ population, through education about surrogacy and adoption issues. “We have to meet people where they are,” she said.

Making Your Program Work for Women

Huertas and Lasky had suggestions for ensuring your program delivers for your employees: 

1.) Look for carriers or programs that have strong networks of specialists across the U.S., or even globally. 

2.) Programs or partners should do their best to integrate with your current health-plan carriers or other associated services and coordinate care to help ease the burden of your HR department. For example, Huertas said, the maternity-management program will refer a user to their company’s employee assistance program (EAP), their short-term disability vendor, mental health and wellness resources, and any other pregnancy-related support programs. “That takes the lift off the employee to track down all those benefits, and how to contact them, and keeps those phone calls and emails from clogging up your inbox and voicemail in the HR department. Having carriers and programs that really work together is going to help alleviate a lot of stress for your department. 

3.) You can’t design it and forget it. “Evaluate the cost impact of offering a service versus not offering it,” said Lasky. “I want to look at employee surveys, the feedback that comes from exit interviews, and during our annual engagement surveys. It may entail looking through thousands of lines of responses. But I don't think that you'll ever walk away from that experience saying, gee, I really wish I wouldn’t have read those comments.”

When Lasky started at Accolade, there was feedback that benefits were primarily focused on women of childbearing age. She reviewed surveys, and exit interviews revealed some gaps, so in 2023, Accolade will add Bloom to its benefits. Bloom provides services related to pelvic health for women of any age. “I think that this is an important way to ensure that our employees know that we’re listening to them. We don't talk about women’s health care issues. I had never heard about pelvic dysfunctions until I started thinking and talking to my peers about Bloom. It just is starting to open that conversation.”

4.) Know if they ease your work burden, said Lasky. “Is the work worth the reward, and does it improve the employee experience? Think of something as simple as file integration and how difficult that can be. If you are sold some solution, but there are 17 different files that must integrate with your system to be effective, maybe you need to reevaluate it.” That alone may not be enough to tip the scale against a vendor if the reward and impact on your employees is enough. “Did it delight and inspire your employees?” Lasky asked. “If so, then all that front-end work was for a good end.”

5.) Be aware of issues and problems. The first time you hear about something shouldn’t be when you are terminating the vendor. Lasky has regular check-ins with new vendors, even after implementation.

6.) Address problems in a timely manner. Lasky said you should track the time it takes to resolve open items. “If you have been trying to change something for 18 months, a vendor shouldn’t be surprised when I say that this relationship may not be working for us.” Check-ins also allow you to alert vendors to trends you notice in the feedback from surveys and exit interviews.

7.) Beware of custom products and services. It can backfire as you grow and as and if your business changes. “It’s hard to maintain the continuity of a bespoke solution,” Lasky said.

Coming Down the Pike

Among the pressing issues Lasky said she sees is the continued politicization of women’s bodies and their health care. “How do we address equal access to health care? That definition should not be owned by politicians, but by our experts in the fields of medicine.” 

Of continued importance are issues related to cardiac disease, depression, and topics that impact women alone, including gynecological health, menopause, and violence against women.

Forecasting future trends in women’s health care is made more difficult because of an ever-evolving patchwork of state and local laws. Issues as seemingly mundane as sick leave can differ drastically from one county to the next. Proposed solutions for how best to address issues of LGBTQ health and trans-gender medicine also change as one moves across political boundaries. 

Huertas said that the best way to move forward is to continue to focus on women’s health care and view it as family health care. “The choices you make to support the women in your employee population have ripple effects on the health of their families, their teams and their work in general. You'll have more satisfied employees and healthier employees overall.”

Editor’s note: From Day One thanks our partner who sponsored this webinar, Accolade, and the session’s moderator, Katie Blakemore, the company’s marketing manager for webinars and events.

Lisa Jaffe is a freelance writer who lives in Seattle with her son and a very needy rescue dog named Ellie Bee. She enjoys reading, long walks on the beach, and trying to get better at ceramics.