National Women’s Health Guidelines Updated

New recommendation for breast cancer screening added.

Breast cancer screenings for average-risk women are now part of the Women’s Preventive Services Guidelines, which were updated in December by the Health Resources and Services Administration (HRSA). A division of the U.S. Department of Health and Human Services, HRSA is the primary federal agency responsible for improving health and achieving health equity for Americans who are geographically isolated, economically or medically vulnerable (including people living with HIV/AIDS, pregnant women, mothers, and their families, as well as under-insured individuals).

The Women’s Preventive Service Guidelines – which affect plan years (or policy years in the individual market) beginning on or after December 20, 2017 – “aim to improve women’s health across the lifespan by identifying preventive services and screenings to be used in clinical practice,” according to a press release issued by HRSA. The guidelines were originally developed in 2011 based on recommendations from a study commissioned by the Department of Health and Human Services, and conducted by the Institute of Medicine (now known as the National Academy of Medicine).

To update the guidelines, HRSA collaborated with the American College of Obstetricians and Gynecologists (ACOG) in March 2016 to create the Women’s Preventive Services Initiative: a coalition of national health professional organizations and consumer and patient advocates with expertise in women’s health across the lifespan, according to the initiative’s website.

The nine updated guidelines include recommendations for:

  • Breast Cancer Screening for Average-Risk Women. The Women’s Preventive Services Initiative recommends that average-risk women initiate mammography screening no earlier than age 40 and no later than age 50. (This guideline was an addition to the original list of eight recommendations, which were updated as follows.)
  • Breastfeeding Services and Supplies. Comprehensive lactation support services – including counseling, education, and breastfeeding equipment and supplies – are recommended during the antenatal, perinatal, and the postpartum period to ensure the successful initiation and maintenance of breastfeeding.
  • Screening for Cervical Cancer is recommended for average-risk women aged 21 to 65 years.
  • The updated guidelines recommend that adolescent and adult women have access to the full range of female-controlled contraceptives to prevent unintended pregnancy and improve birth outcomes. (This guideline does not apply to women who are participants or beneficiaries in group health plans sponsored by religious employers.)
  • Screening for Gestational Diabetes Mellitus is recommended for pregnant women after 24 weeks of gestation (preferably between 24 and 28 weeks of gestation) in order to prevent adverse birth outcomes.
  • Screening for Human Immunodeficiency Virus Infection. The guidelines recommend prevention education and risk assessment for human immunodeficiency virus (HIV) infection in adolescents and women at least annually throughout the lifespan.
  • Screening for Interpersonal and Domestic Violence is recommended for adolescents and women at least annually, and, when needed, provision of or referral to initial intervention services.
  • Counseling for Sexually Transmitted Infections. The guidelines recommend directed behavioral counseling by a healthcare provider or other appropriately trained individual for sexually active adolescent and adult women who are at an increased risk for sexually transmitted infections (STIs).
  • Well-Woman Preventive Visits are recommended at least once per year beginning in adolescence and continuing across the lifespan, to ensure that the recommended preventive services, including preconception, and many services necessary for prenatal and interconception care, are obtained.

From the HRSA press release: “Thanks to the Affordable Care Act, more than 55 million women with private insurance now have access to a full range of preventive services like mammograms, flu shots, and contraception without a copay or deductible. By law, certain health plans or health insurance issuers are required to cover specified preventive services without a copayment, coinsurance, deductible, or other cost-sharing, including preventive care and screenings for women as provided for” in the HRSA-supported Women’s Preventive Services Guidelines.

In comments emailed to Repertoire, Maggie McEvoy, ACOG’s media relations manager, wrote that in the coming years, the Women’s Preventive Services Initiative – which is part of a five-year cooperative agreement between HRSA and ACOG – “will continue to develop recommendations on an annual basis and submit them to HRSA for consideration and acceptance.” The initiative also plans to launch an Implementation Steering Committee beginning March 2017, “in order to develop tools for providers and patients to help implement” the guidelines.

To view the full updated set of Women’s Preventive Services Guidelines, visit https://www.hrsa.gov/womensguidelines2016/index.html.

To view the HRSA press release, visit https://www.hrsa.gov/about/news/pressreleases/161220womensguidelinesupdates.html.

For more information on the Women’s Preventive Services Initiative, visit http://www.womenspreventivehealth.org/.

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