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Resources Aim To Address Implementation Gaps in ACA's Well-Woman Visit Benefit

Resources Aim To Address Implementation Gaps in ACA's Well-Woman Visit Benefit

March 26, 2015 — Summary of "Well-Woman Visits: Guidance and Monitoring Are Key in This Turning Point for Women's Health," Fitzgerald et al., Women's Health Issues, March 2015.

Although the Affordable Care Act's (PL 111-148) preventive services provision requires insurers to cover at least one annual well-woman visit (WWV) without cost-sharing, there is a dearth of "guidance, education, and outreach associated with implementation of WWVs," leaving "many women ... unaware of the benefit," according to Therese Fitzgerald of the Mary Horrigan Connors Center for Women's Health and Gender Biology and colleagues from the Connors Center, National Women's Law Center and Brigham & Women's Hospital's Division of Women's Health. They note that the issues have "jeopardize[d] women's access to key preventive care services."

For example, research has shown that 40% of women do not know about the ACA's WWV benefit and that 20% of women delayed preventive care because of cost. Such findings "are not surprising given the lack of education and outreach on WWVs," according to the authors. For instance, some HHS fact sheets about women's health services do not mention WWVs, an omission the authors call "as objectionable as [the sheets'] failure to include contraceptive services and supplies."

To address implementation issues related to the WWV benefit, Fitzgerald and colleagues' associated groups, along with Pfizer, have created "resources for consumers, providers and policymakers on WWVs to ensure that women are able to understand and access" the preventive care services offered under the ACA.

Consumer Guide to WWVs

The groups consulted with an advisory panel comprised of health and policy experts to draft a "consumer-friendly resource that can be used to educate women about this new benefit." The guide is offered in two languages and is "health literacy-appropriate."

Fitzgerald and colleagues explain that the guide includes information on "what to expect at a WWV," as well as answers to frequent questions about the visits, such as:

~ What is a WWV?;

~ How much do WWVs cost?; and

~ What happens during WWVs?

The guide also includes information on how women should prepare for a WWV, as well as links to other resources.

In addition, the groups created a toolkit for consumer advocates and providers on WWVs to help them educate women about the visits and "what they mean for women's health." The toolkit has:

~ Factsheets and other resources about WWV best practices; and

~ Information about how WWVs can help to improve women's health throughout their lives.

Policy Issue Brief

The groups also created "an issue brief for primary care providers and policymakers" about ways that "changes in health care delivery can improve the availability and use of education and counseling" through routine visits. The brief also describes ways to "improve the successful integration of education and counseling services into women's primary care," the authors wrote.


Fitzgerald and colleagues note that "WWVs are a key component and gateway to the constellation of preventive care now consistently available to women under the ACA." They write that additional resources for "consumers, providers and policymakers on WWVs will empower more women to access comprehensive, personalized, preventive care."

Further, they call for HHS to "monitor the utilization of preventive" services "by collecting, analyzing and reporting data" on how women are using WWVs and the effects of such visits on the "receipt of recommended preventive care." Such data are important to gauge whether the ACA preventive care provisions have "been fully implemented and to determine if there are barriers for women, particularly marginalized subgroups of women, in gaining access to this valuable preventive resource," Fitzgerald and colleagues conclude.