In a quiet but competitive building boom, Minnesota hospitals and health systems are spending millions of dollars on clinics and medical services that beckon an increasingly important group of patients: Women.

The projects, which total more than $136 million over the last five years, include swank new maternity suites but reach well beyond obstetrics and gynecology to include cancer care, mammography, mental health and even acupuncture and massage.

Hospital executives have always known that women are key health care decisionmakers for themselves and their families. But the marketing push has taken on a new urgency as systems find themselves competing more and more on cost and quality to serve the entire life span of their patients.

"Statistically, pretty close to 80 percent of all household health care decisions are made by the female," said Maureen Swan, an Eden Prairie-based health care consultant. "They are a core customer beyond their own health care consumption."

For that reason, maternity wards have long been called health care's front door. But now, health systems are building other front doors to attract women.

These include dedicated women's clinics, which place multiple specialties under one roof, like the $28 million Women's Health Pavillion at Olmsted Medical Center in Rochester or the $9.7 million Park Nicollet Women's Center in St. Louis Park.

Others take the form of convenience services that help women navigate a system's primary and specialty clinics. St. Paul-based HealthEast Care System last year started a women's concierge phone line, a centralized resource for appointments and health information.

"No one has time to go to one appointment and then be told they have to make an appointment with some other provider," said Dr. Krista Skorupa, women's care program director for HealthEast. "We give a one-stop shop for women … someone at the end of the line to connect them to providers across our system."

Allina Health System, based in Minneapolis, has spent more than $40 million on new Mother Baby centers at Abbott Northwestern and Mercy hospitals, and is now adapting its network of primary clinics to add services that appeal to women, such as wellness care and massage.

Consumer choice

The emphasis on women's health care comes at a time when the customer pool of insured Minnesotans is expanding sharply. Some 30,000 Minnesota women of reproductive age gained health insurance in the past year, part of a huge surge as the individual insurance mandate of the Affordable Care Act became effective in 2015.

Hospitals and clinics are also bracing for changes in the way the nation pays for medical care. Although reforms will likely take years to roll out, providers are gearing up for the day when they get paid for medical outcomes rather than just for the number of the procedures they perform.

One key to successful outcomes will be to coordinate all of the care that a woman and her family will need.

In addition, consumers with employer health insurance find themselves paying more costs out of pocket, and it is not unusual for some families to pay thousands of dollars in deductibles or "copays" before insurance kicks in.

Health care organizations "can't rely on the old model of assuming that consumers are going to the closest clinic or where the doctor refers them," said Swan. "They are looking at price, they are looking at the features that are being offered."

Too busy

HealthPartners was one of the first in the Twin Cities to offer a specialized women's clinic that went beyond traditional care.

"The uniqueness at the time was having primary care co-located with gynecological and obstetrics," said Dr. Beth Averbeck, associate medical director for primary care at HealthPartners. "Previous to that, you would go to one, and if you got hypertension and diabetes you would go to a different clinic."

The HealthPartners Center for Women, which opened in 1986, includes mammography, acupuncture, ultrasound and mental health care, and serves about 7,000 patients annually.

Park Nicollet Health Services, which merged with HealthPartners in 2013, expanded the concept last year when it opened its women's center, which brings together doctors from more than 15 specialties.

"We asked women through focus groups what services they would like to see in a central location," said Andrea Winter, senior director of women's services. "Anecdotally we know women are really good at taking care of others, but often [leave] themselves at the bottom of the list," Winter said. "It is about making a comfortable environment where women feel they can relax a bit and take control of their health."

Ginny Ogle of Edina, who had her first son six weeks ago, said she appreciated the convenience and care coordination of the Park Nicollet Women's Center. A clinic employee now on leave, Ogle said it's helpful to have all the services in one place.

When she developed nausea and sleep problems during her pregnancy, she was able to get relief through the clinic's acupuncture services.

"I know my care team is talking and I have trust in what they are telling me," Ogle said. "The convenience was the biggest thing for me because I am so busy," she said. "Going to … appointments in several different buildings would just be too overwhelming."

While the investments can improve care and market appeal, they are also an investment in the future.

"In general, hospitals don't tend to make money on maternity care," said Swan. "They are building a relationship with the key decisionmaker in that home."

Glenn Howatt • 612-673-7192