Industry

‍Women's health, Digital health

Use Case

Benchmarking, Cost and utilization analysis

Challenge

‍Understanding the cost impact of the menopause care gap

Over fifty million women in the US are navigating menopause today. They face a massive care gap due to a lack of adequate provider training, stigma around women’s health and aging, and confusion around hormone therapy. Symptoms related to menopause remain overwhelmingly underdiagnosed and undertreated despite this being a universal experience for women. Furthermore, research increasingly ties chronic disease risk in women with the menopausal decline in hormone production. Elektra Health sought to better understand the cost impact of this care gap in terms of menopause symptoms and comorbid conditions (e.g., metabolic syndrome) and highlight the need for additional focus and care in this area.

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Solution

Benchmarking, and analyzing comorbidity segmentation

Elektra Health partnered with Accorded to analyze the hidden cost burden associated with gaps in menopause care by performing service benchmarking and comorbidity segmentation analyses. Accorded’s configurable actuarial analytics allowed Elektra’s team to customize a target population definition and identify the cost impact of a menopause diagnosis on common comorbidities.

Impact

Publishing the first study of its kind in a decade

The resulting actuarial claims analysis unearthed key findings, including:

• Only ~19% of women between ages 40 to 60 received a clinical menopause diagnosis, according to the claims data, even though up to 80% generally experience symptoms, according to clinical literature.
• The population who received a clinical menopause diagnosis incurred 45% more healthcare costs, on average, per year.
• For patients diagnosed with menopause, comorbid conditions such as metabolic disorders, hypertension, and joint pain are both more prevalent and costly compared to undiagnosed patients: 37% and $2,572, 14% and $4,133, 38% and $3,965, respectively.

Using findings from Accorded’s analyses, Elektra Health published its Actuarial Menopause Cost Report in 2023, which has been covered in Becker’s Healthcare and MedTech Pulse, among others.