Interview

Redefining Whole-Woman Care

Suzin Cho, MD, is a practicing OB/GYN and the president of Almara Women’s Health

Please tell us a little about the process that led to the formation of Almara Women’s Health.

Almara Women’s Health was formed in June 2025 through the unification of seven long-standing, independent physician-owned clinics across the Twin Cities. These clinics, some of which have been in operation for 40 years, comprise ten locations and more than 65 women’s health specialists. There were many shared skills between the practices although each had certain highly specialized skills that, under one name, expanded the spectrum of care we could provide. Our concept in creating a new entity entailed creating a shared vision of whole-woman, relationship-based care, a model that better reflects the complexity of women’s lives.

Beyond this fundamental guiding principle were several immediate more business-related benefits. Things such as increased negotiating leverage with payers, lower supply costs and better vendor contracts were all enhanced by working as a single entity. In addition, there are considerable benefits that create economies of scale around consolidated recordkeeping in both EHR and billing related concerns.

Unlike corporate or private-equity-driven systems, Almara is wholly physician-owned. This allows clinicians to prioritize patient needs over profit, integrate services, and innovate without unnecessary administrative oversight, unrealistic and potentially harmful guidelines concerning patient interaction times and procedures, or related external interference.

Can you add a little further background?

Physician-owned practices have been declining for decades. Initially, this decline involved vertically integrated systems and later it was through private equity and hedge fund buyouts.

As physicians, we were asking: What do we give up in terms of quality, access and innovation as the demands for profitability grow? And specifically, what does this mean for areas of care that have been under-resourced, such as routine care, preventive medicine, mental health and women’s health services? 

In 2019, several independent, physician-owned medical practices across various specialties in the Twin Cities came together to form i-Health Collaborative. Its purpose is to refocus health care delivery on patient choice, physician autonomy, quality and value-based care. 

Almara as a division of i-Health comprises seven physician-owned clinics. Our collaboration was initially built on two main objectives. The first was to expand patient care services, which no one clinic could do on its own. For example, a screening program for patients at intermediate and high risk for breast cancer was created in partnership with Minnesota Oncology and Hematology. Related collaborative expansions included: a full-service gestational diabetes management program with dietician services and consultation with maternal fetal medicine; a pelvic floor PT program.

The second objective was to create business efficiencies and lower costs through shared administrative services and shared leases and supply contracts while also achieving more favorable shared payer contracts As the relationship between the members of Almara matured, it became evident that converging marketing efforts would amplify the voice of independent physicians amidst large health care systems and private equity-owned practices.

What are some of the biggest misconceptions people have when they hear the term “Women’s Health Care”?

Many people assume “women’s health care” is limited to reproductive services or OB care. They think that women’s health care is limited to contraceptive care, Pap smears and pregnancy care. They may not realize, however, that within reproductive concerns, ranging from birth control to pregnancy, and birth to menopause, there are ever increasing medical advances that can make significant improvements in our patients’ lives.

Women’s health is really a whole-person endeavor that involves a wide array of concerns beyond those involving reproduction. These include specific heart and metabolic health issues, sleep health, bone strength, aging and autoimmune diseases. It also involves being part of a care team that includes other medical specialists such as an oncologist or orthopedic surgeon, mental health providers and others.

A common misconception is that women’s health care is episodic or one-size-fits-all. Our approach is highly personalized, grounded in science, and designed for continuity — from adolescence through menopause and beyond. For many patients, OBGYNs serve as their primary access point to health care by overseeing disease prevention and health maintenance from the teen years through menopause and beyond.

One of our guiding principles is to empower our patients to be their own advocates.

Genetic testing and counseling are becoming an increasingly standard part of pregnancy care. Please share some of how you approach this.

We offer carrier screening both prenatally and during pregnancy, as well as a range of genetic screening and testing options during pregnancy. With a maternal fetal medicine specialist and a genetic counselor on staff, patients can receive in-depth counseling and testing based on risk factors such as advanced maternal age, family history of disease, and past pregnancy history. The general OBGYN clinics provide routine screening with ultrasound and antepartum ultrasound surveillance; while the Maternal Fetal Center performs advanced ultrasound services including comprehensive anatomic surveys and fetal echocardiograms. 

In the realm of cancer screening, we help patients understand their risk factors and connect them with the right genetic counselors for testing. We help them recognize potential familial conditions such as BRCA gene mutations and other familial breast cancer syndromes, Lynch syndrome and Factor V Leiden mutations and make referrals to genetic counselors outside of Almara when needed.

Mental health during postpartum care is important. How do you assist patients with these issues?

We screen for mental health risk factors at annual well woman visits, during routine prenatal care and at postpartum visits by actively asking questions that can bring problems to light and identifying risk factors. Our physicians can start and manage medications and educate patients regarding non-medical interventions, while also connecting patients with therapists and psychiatrists when required. We often work in partnership with a patient’s therapist. We also recognize when a specialist should manage a patient’s mental health. We offer mental health services across the lifespan, not just during pregnancy.

What are the biggest insurance reimbursement issues in women’s health care?

Improving women’s health care requires addressing systemic insurance reimbursement issues that disproportionately affect women’s health outcomes. Maternity care is bundled into a single payment. While designed for administrative simplicity, this structure creates significant reimbursement inequities, resulting in delayed payments to providers until after delivery. When the three components, prenatal care, delivery and postpartum care, are billed separately, the total payment is less than the global fee. This discrepancy is retained by the insurer, rather than being paid to the provider for the services rendered. 

The current system fails to account for the full scope, time and complexity of high-risk pregnancies or maternal comorbidities. Postpartum care is undervalued and inadequately funded. In addition, nontraditional services like mental health screenings, nutrition counseling or care coordination are not covered despite being standard of care.

What kinds of policy changes could best address these Issues?

First of all, reimbursement should allow fair unbundling of services without financial penalty to the providers. We must reform reimbursement to reflect service intensity, especially for high-risk pregnancies. Another important element would expand postpartum care reimbursement to one year, as well as provide incentives for early and preventive pregnancy care.

Infertility treatment is often excluded from coverage and disproportionately affects women with underlying conditions such as PCOS and endometriosis. Determining coverage exclusions or prior authorization requirements is costly and time-consuming, resulting in a significant financial burden on the provider of care. 

Infertility should be viewed as a continuum of reproductive health and in all cases payers should remove prior authorizations for evidence-based care.   

Finally, we should mandate coverage parity for chronic conditions that impact reproductive health or disproportionately affect women.

Please discuss the importance of maintaining the independent practice of medicine.

The practices that have come together as Almara did so because they are committed to remaining independent and physician owned. Being physician owned means having the ability to make referrals based on expertise, not based on closed networks. It allows doctors to adopt innovations quickly, without waiting for administrative green lights based on extended cost-benefit projections that will most likely be outdated before they achieve a high enough profitability. Similarly, it allows physicians to focus on quality and relationships rather than volume metrics.

We can perform office-based or ambulatory surgeries and procedures, which decrease health care costs and increase patient satisfactions and improve outcomes, rather than being forced to refer to hospital-based procedures, which incur large facility fees. Women’s health is our sole focus. Physicians in the exam room with the patient are the ones making decisions about how we provide care. Independent practice also creates a healthier work culture for physicians themselves. It promotes a sense of ownership, engagement and impact, which in turn reduces burnout and restores their purpose in medicine.

One of our guiding principles is to empower our patients to be their own advocates. We want them to know as much as possible about their health care and their choices and options. Independent practice allows us to maintain these professional values without fear of compromise. 

What can you share about your plans for expanding the Almara footprint?

We are keeping an eye on growing markets around our community, which need more access and choice. Also, we are focused on developing new services and programs, building additional referral partners and physician recruitment. Growth will focus on expanding both physical access and digital resources that will expand women’s access to well-vetted health information. We are open to innovative ways of collaborating with medical practices in Greater Minnesota to help improve women’s health, and there are several of them. In some cases we have worked directly with self-insured employers, and even in other states, to provide surgical services that are more cost-effective and provide a more positive patient experience than may be available in smaller markets that offer only hospital options. 

Is there anything else you would like to share with our readers?

The physicians at Almara have dedicated their lives to promoting women’s health. It’s all we do. We want to partner with patients at any stage or age and be there with them for the whole journey.

To all of our many medical colleagues, from every area of specialty, who have referred patients to any of the clinics that have joined to form Almara, we assure you that these patients will continue to receive the high level of care you have come to expect.  

We recognize the challenges women face in finding great care. Information is often hard to find, and people can be hard to reach. Practices and physicians are often difficult to distinguish from one another. Yet, building a long-term relationship with a physician has a significant impact on health and longevity. We’re here to be a woman’s personal guide, supporting her through every decade of her life with knowledge, compassion, and clinical excellence. Our mission is to redefine what whole-woman care means — not as a collection of body systems or life stages, but as a lifelong journey of informed, integrated support.

Suzin Cho, MD, is a practicing OB/GYN and the president of Almara Women’s Health.