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5 ways shift-of-site care is a win for all women

With unique needs, women benefit greatly from a wider array of care options. Payers and employers can reap big rewards by providing them.

June 5, 2023 | 6 minute read

For generations, the operative word in the phrase “going to the doctor” was going. As in, venturing to a doctor’s office or hospital to receive needed health care, often at significant cost such as missing work or arranging for childcare or transportation. One study revealed that Americans travel an average of 34 minutes to see a physician, and that the economic cost of both traveling to and waiting for health care services tops $89 billion annually.1 And that’s if they can reach a doctor at all: More than 80% of the counties in the U.S. qualify as “care deserts,” with little to no health services options available.2

For many people, these personal costs have simply been too high, and often the most feasible option has been to forego the visit altogether. The net result? A dearth of preventive care for those affected, ultimately leading to poorer health outcomes down the line. Missing out on screenings and other forms of preventive care is a serious matter. In fact, up to 100,000 lives could be saved each year if Americans fulfilled annual screening recommendations.3

Thankfully, this long-standing model of in-hospital or in-clinic health care visits has seen extensive disruption in recent years, with telehealth becoming ubiquitous and hospital-at-home treatment methods gaining steady momentum. Urgent care facilities are helping to mitigate the distance gap that affects so many Americans. Drugstore chains now offer services ranging from blood pressure readings to immunizations. The American Hospital Association also reports that 75% of hospitals employ virtual or video telehealth solutions to connect with patients, and 61% now have the capacity to monitor patients remotely.4 At last count, 277 hospitals in 37 U.S. states had been approved to offer hospital-at-home services.5

Even better news: These shift-of-site services tend to cost significantly less, and hospital-at-home services have been shown to be safer than a hospital visit for some patients.6 And research reveals no dip in the quality of care between acute remote health services and those offered in person.7 But there is a further benefit to these innovative shift-of-site solutions, which is that they can better meet the unique needs of an often-underserved group: women. For reasons of cost, convenience and other circumstances specific to women’s lives, making health care easier to access from home is a lifesaver to this population. Here’s why.

Shift-of-site services help women bridge the cost and time barriers that can keep them from receiving care. A 2023 Ipsos survey revealed that 45% of women have skipped a doctor’s appointment, screening, treatment or vaccination. Why? Cost of care (25%) and lack of time (23%) top the list.8 Cost is a bigger barrier to care for women than men, a survey in the Journal of the American Medical Association found: 3.9% of the women surveyed said they could not afford health care compared to 2.7% of survey respondents who were men.9 Telehealth and hospital-at-home care models, however, generally cost less than in-person visits, which can help to ease this burden. In fact, telehealth can cut members’ out-of-pocket costs by up to $100 per visit10 and hospital-at-home care can reduce costs by 30% or more.11

Virtual, in-home and off-site care can also help reduce or eliminate the need for travel, childcare arrangements and missed work that many women face with solely on-site services. And they’re popular, too. Women enrolled in a program that combined remote monitoring and telehealth appointments with 8 on-site appointments for perinatal care — down from a typical 12 to 14 — reported higher levels of satisfaction and lower levels of stress than women who attended on-site appointments alone.12

Virtual care is suited to many of women’s health care needs. According to figures released by the CDC, telemedicine is more popular among women: 42% of women surveyed use it compared to only 31.7% of men.13 This fact dovetails nicely with the telemedicine-readiness of many of the health care needs women have. Reproductive health services like contraception consultations, checkups related to gestational diabetes, or visits with lactation consultants are often performed remotely with no dip in quality.14,15 Management of heart disease — the number one health threat women face — can also be augmented virtually.16 For example, doctors can use data from connected weight scales to detect changes in patients with congestive heart failure. And metrics such as blood pressure that patients track at home can be combined with in-person or virtual visits to supplement care.

Women need behavioral health and postpartum services — meeting them where they are can help. A 2022 survey on women’s health found that more women felt they needed mental health care than their male counterparts (50% versus 35%), yet only 40% sought treatment.17 The workplace is one area where people feel least comfortable talking about mental health issues, but it’s an area where big gains can be made. Another study found that the most desired mental health resources in the workplace are a more accepting culture, mental health-related training, and better information on where and how to seek support for mental health issues.18 More support equals better employee engagement, retention and recruitment, the survey revealed.

Support for working mothers is particularly critical. Yet less than 20% of pregnant or postpartum women are screened for depression19 and a 2022 report published by researchers at The Ohio State University revealed that a staggering 68% of working moms struggle with chronic burnout, as compared to 42% of working fathers.20 If telehealth visits, hospital-at-home services, virtual therapy sessions, or off-site screenings can diminish these feelings of being overwhelmed, that goes a long way toward reducing the burden — and toward safeguarding this population’s health. Take support and resources for working women to continue breastfeeding: CDC research shows that when women are given the space, time and support to continue breastfeeding while working, many more do so. And the benefits are myriad: happier employees and decreased absenteeism, health care costs and employee turnover.21

While it’s clear that changes to the ways — and locations — in which Americans access medical care are good for us all, these seismic shifts have the potential to mitigate the particular health care gaps that affect women most. By meeting women where they are and reducing the physical, financial and logistical burdens of accessing care, payers can ensure greater adherence to preventive care among women members, as well as a more ready adoption of mental health interventions that can positively impact members’ physical health. The formula is simple: the easier it becomes to access care, the more people will do so. And the more people receive the care they need, the more everyone succeeds.

Learn more about Optum Women’s Health Solutions for health plans and employers.


  1. Altarum. Travel and wait times are longest for health care services and result in an annual opportunity cost of $89 billion. Accessed April 14, 2023.
  2. GoodRX. Mapping healthcare deserts: 80% of the country lacks adequate access to healthcare. Accessed April 14, 2023.
  3. Centers for Disease Control and Prevention. Access to health care. Accessed April 14, 2023.
  4. American Hospital Association. Fact sheet: Telehealth. Accessed April 14, 2023.
  5. Centers for Medicare & Medicaid Services. Approved facilities/systems for acute hospital care at home. Accessed April 14, 2023.
  6. DeCherrie L, Leff B, Levine D, et al. Hospital at home: Setting a regulatory course to ensure safe, high-quality care. The Joint Commission Journal on Quality and Patient Safety. 2022; 48(3)180–184.
  7. Levine DM, Ouchi K, Blanchfield B, et al. Hospital-level care at home for acutely ill adults: A pilot randomized controlled trial. Journal of General Internal Medicine. 2018; 33(5):729–736.
  8. Alliance for Women’s Health and Prevention. New IPSOS survey reveals nearly half of American women forgo preventive care services. Accessed April 27, 2023.
  9. Gupta A, Pagán JA. Trends in reported health care affordability for men and women with employer-sponsored health insurance coverage in the US, 2000 to 2020. JAMA. (2022).
  10. Cigna. Convenient, cost-effective, and high-quality virtual care is here to stay. Accessed April 14, 2023.
  11. Commonwealth Fund. Hospital at home programs improve outcomes, lower costs but face resistance from providers and payers. Accessed April 14, 2023.
  12. Butler Tobah Y, LeBlanc A, Branda ME, et al. Randomized comparison of a reduced-visit prenatal care model enhanced with remote monitoring. American Journal of Obstetrics & Gynecology. 2019; 221(6)628.E1–638.E8.
  13. Centers for Disease Control and Prevention. Telemedicine use among adults: United States, 2021. Accessed April 14, 2023.
  14. Kaiser Family Foundation. Telemedicine and pregnancy care. Accessed April 14, 2023.
  15. Cantor A, Nelson H, Pappas M, et al. Telehealth for women’s preventive services for reproductive health and intimate partner violence: A comparative effectiveness review. Journal of General Internal Medicine. 2023.
  16. Takahashi E, Schwamm L, Opeolu A, et al. An overview of telehealth in the management of cardiovascular disease: A scientific statement from the American Heart Association. Circulation. 2022; 146(25).
  17. Kaiser Family Foundation. Access and coverage for mental health care: Findings from the 2022 KFF Women’s Health Survey. Accessed April 14, 2023.
  18. Harvard Business Review. Research: People want their employers to talk about mental health. Accessed April 27, 2023.
  19. Sudhanthar S, Sheikh Z, Thakur K. Postpartum depression screening: Are we doing a competent job? BMJ Open Quality. 2019; 8(4):e000616.
  20. The Ohio State University. Examining the epidemic of working parental burnout and strategies to help. Accessed April 14, 2023.
  21. Centers for Disease Control and Prevention (CDC). Support for breastfeeding in the workplace. Accessed April 27, 2023.