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In This Issue:
BWH’s Paula Johnson, MD, MPH, chief of the Division of Women’s Health and executive director of the Connors Center for Women’s Health and Gender Biology, participated on an Institute of Medicine (IOM) panel that released a report on women’s preventive services they believe insurers should cover in full.
On Aug. 1, the Department of Health and Human Services approved the panel’s recommendations, which are in addition to the services already required by the Affordable Care Act. A review of scientific evidence by the committee resulted in eight recommendations. New health insurance plans will be required to begin covering certain services without cost-sharing or co-pays, such as for contraceptives, breast pumps and preventive care visits, on or after Aug. 1, 2012.
“National health care reform and the recommendations regarding prevention, and now the addition of specific recommendations for women, really provide an unheralded opportunity to improve the health and well being of the entire population and, in particular, women,” Johnson said.
In an interview with BWH Bulletin, Johnson explains the panel’s recommendations as well as how BWH is focused on improving the health of women in many of these areas.
Q.Why is it important to focus on women’s health in particular?
A. We’ve come to learn that there are significant differences in health and disease for women. That’s the basis of our work at the BWH Connors Center. Over the last six months, the IOM panel took a comprehensive look at the evidence supporting whether additional services should be provided for women not only to prevent disease, but also to promote health and well-being.
Q. What are the recommendations?
A. The eight recommendations include:
Routine annual screening for sexually transmitted diseases for all sexually active women.
Annual HIV screening and counseling for all sexually active women.
In addition to routine pap smears, high-risk DNA testing for women over age 30. This increases care providers’ ability to detect cancer.
All FDA-approved contraceptives and sterilization methods be covered for women at no cost. We have excellent data on the preventative benefit of decreasing the rates of unintended pregnancy in the U.S. and promoting healthy spacing of pregnancies.
Breastfeeding counseling be offered to all women while pregnant and upon birth and costs of renting breast pumps be covered. We know the benefits of breastfeeding to both the child and mother. We also know that the majority of women return to work after a maternity leave, and it’s important that cost should not be a barrier to them as they continue breastfeeding.
Coverage of screening and counseling for interpersonal and domestic violence. Women are at an increased risk, and we have strong data that show these services often lead to decreased risk.
At least one preventive care visit per year. We need the ability for women to go to their care provider and have counseling to ensure they receive these all of the services I mentioned. Women’s primary care tends to be more fragmented, as we receive care from both an internist and an obstetrician/gynecologist. Having at least one of these visits covered without a co-payment is very important.
Q. What are we doing at BWH to improve the health and well being of our female patients?
A. At the Brigham, we are focused in a very powerful way on discovering sex and gender differences in health and disease, and how we should provide care differently to women based on the evidence. For example, an area of focus at BWH is lung cancer and how the disease differs in women. Smoking is one of the most important risk factors for lung cancer, and women are more likely than men to become addicted to nicotine—that’s a biological fact. In the IOM report, we clarified the current recommendation by the U.S. Preventive Services Task Force to make sure that women (and men) have access to a full range of smoking cessation aids—they frequently need more than one—in addition to counseling. This is an example of BWH conducting important research that will continue to provide data to improve the care of women.
There are investigators and clinicians working to develop new strategies to decrease women’s risk for gestational diabetes and to improve care for women with gestational diabetes. These include preventing gestational diabetes in future pregnancies and decreasing the risk of cardiovascular disease. In addition, we’re engaged in family planning research, which highlights the power of prevention and contraceptives.
These are just a few examples of areas where we are discovering how women’s health is different and how to improve the care we provide to women, based on science.
Learn more about the IOM Committee Recommendations for Preventive Services for Women with This Video.