August 27, 2007

Women's Health

We recently discussed Men’s Health in an article and how men lag behind women in preventive healthcare. However, as a society both men and women in America must seek to improve wellness for themselves personally. This personal wellness theme ties directly to employer offerings of health insurance.

Women’s preventive healthcare is a broad area of healthcare. According to the US Department of Health and Human Services (HHS), women should seek preventive health screenings for the following areas: general health, heart health, bone health, diabetes, breast health, reproductive health, colorectal health, eye and ear health, hearing test, skin health, oral health, mental health screening and immunizations.

What a comprehensive list! Fortunately, women largely adhere to the advice of their gynecologist and seek well-women examinations at a very high rate. Nationally, 96.2% of women above age 65 have a usual source of preventive medical care which usually consists of breast and cervical examinations. In contrast, 81.9% of women between ages 18 to 24 have a usual source of medical care. This information is taken from a study from The Centers for Disease Control and Prevention, National Center for Health Statistics.

However, the comprehensive list above represents a broader area of wellness than what has typically been promoted through legislation and normal health insurer health maintenance planning for preventive screenings. More must be done to promote the broad wellness screenings suggested by HHS.

Today as we enter an era of consumer directed healthcare, women will have more reasons to seek the broad spectrum of preventive healthcare mentioned above. However, there are challenges. Will your employer provide coverage for each of these screenings? Will the underlying health plan cover these screenings without significant money required by the employee?

These are important considerations for an employer seeking to initiate a wellness plan through a consumer directed healthcare (CDH) offering. One of negatives of CDH plans is that the underlying health plan may only have state mandated benefits which only address components of the women’s preventive health screenings recommended by HHS.

Employers and employees alike have reasons to broadly seek 100% usage of women’s health screenings. Early detection of any ailment will allow better treatment, higher survival rates, increased work productivity, lower absenteeism and lower personal health employer health costs. This is not news to anyone but the likelihood of an employer promoting the full scope of women’s wellness suggested by Health and Human Services is very low. For years employers have brought in Mobile Mammography services to their employer site.

We are in an era where benefits are being taken away as employers raise deductibles and liability. In Ohio, there are mandates on women’s breast and cervical screenings according to the Kaiser Foundation’s State Health Fact but the remaining suggested preventive measures by HHS are not mandated to be covered but probably are covered under your health plan.

However, covered really means you pay for it in the form of a deductible or coinsurance. As these liabilities rise the employee has greater financial liability to pay for preventive health care. Alternatively, an employer could set up a wellness strategy for women that pay’s for all of HHS suggested initiatives. Sure this would be an upfront cost that may only get returned years later. In the short-term, expenses will rise to fund the costs of these screenings but the long-term impact may be huge.

So where does this leave us? We are in an era of benefits changing that means women may have greater liability with their health plan. Ohio laws only require health insurers to cover two of the 13 HHS recommended health screenings and your health plan may cover the other 11. However, this will cost you some bucks. Talk to your employer about forming a women’s health steering committee to address the inclusion of broader wellness benefits.

As CDH plans become more accepted, both the employer and employee have many reasons to promote women’s wellness. A steering committee will begin to build a culture that accepts responsibility for overall wellness. In addition, a steering committee will have an integral role in building a CDH plan that they have helped build. The health era of consumer insulation from cost and choice is concluding. Women’s health choices are increasingly becoming both the responsibility and incentive for employer and employee alike.

Filed under Preventive Care, Women's Health, Health Insurance by Scott Cooper