Women-owned and -led virtual providers could increase awareness and provide more comprehensive care for women's health.
Awareness of the gender health gap has grown in recent years, with calls for more gender-sensitive care throughout the industry. While progress has been made, the telehealth industry has the potential to lead the way toward more comprehensive care for women.
Rachel Blank is the founder and CEO of Allara, a telehealth provider specifically for women's healthcare. The idea for Allara came from Blank's own frustrations from when she was diagnosed with polycystic ovary syndrome (PCOS) and struggled to find the comprehensive care that she needed. PCOS affects one in seven women.
While Allara was able to secure venture capital funding, Blank stated that only about 2% of venture funding goes to female led startups.
"If we think about increasing treatment and awareness for women's health conditions, I think it can be hard for men because they don't have the lived experience to know what it's like," she said. She added that if there aren't women leading companies for women's health, in venture funds investing into women's healthcare, or even working at the insurance level, it can be hard to understand why women's health is so important.
Blank began to take her care into her own hands, doing research, learning how to manage her condition, and she found that many other women were struggling with the same issue.
"When we think about living with chronic conditions, you really need more touch points than just that annual [gynecologist] visit," Blank explained. "Women should still be seeing their primary care [gynecologist], their primary care providers; but, if you are a woman with high complexity care needs like PCOS, that's just not sufficient for your care."
She described Allara as an "add-on service" that offers specialty care for more complex, ongoing healthcare needs. Currently, Allara is focused on care for PCOS and endometriosis, but she hopes to grow Allara to treat more complex health conditions.
As a telehealth provider, Blank sees Allara's potential to connect women to expert specialists who they currently may not have access to. Noting the fact that there are only 1,300 reproductive endocrinologists in the U.S., for women who don't live in major cities or reside in rural areas, it's difficult to access the expert care they may need, she said.
After launching last year, Allara is currently servicing women in 15 states, working toward nationwide availability by the end of 2022, with over 15,000 women on its waitlist. Community building through educational social and digital content has been a large part of Allara's growth strategy.
"The interesting thing about the conditions that we're serving, PCOS and endometriosis, is [that] the pain point is so high that we have a captive audience of women who are desperately seeking answers, who are desperately seeking better resources, and have not been able to find them," Blank said.
A new study digs into the reasons why women are not having regular cervical cancer screenings.
January is cervical cancer awareness month, and new data shows there is a declining rate of cervical cancer screenings among women.
While it's recommended that women get screened for cervical cancer every 3–5 years according to age, risk, and type of testing done, a study by the JAMA Network Open surveyed 20,557 women (aged 21–65) across sociodemographic groups who were eligible for cervical cancer screening, and found that the proportion of women overdue for a screening had gone up from 14.4% in 2005 to 23% in 2019.
Findings also showed "substantial variation in cervical cancer screening rates" by ethnicity, LGBQ+ identifying women, women living in rural areas, and uninsured women.
The study authors surveyed the women about reasons why they were not getting screened and found that the biggest barrier across sociodemographic groups cited was "lack of knowledge" about screening being needed.
The authors recommended that "campaigns addressing patient knowledge and practitioner communication may help to improve cervical screening rates, and cultural adaption of interventions is needed to reduce existing disparities."
Dr. Maurie Markman, a medical oncologist and president of medicine and science at Cancer Treatment Centers of America, called the results of the study a "catastrophe," emphasizing the importance of getting screened regularly, as well as the importance of both men and women getting vaccinated for human papillomavirus (HPV), which can cause cancer in the cervix as well as in the head and throat.
"We have the potential of coming as close to eliminating a cancer as one can come to," Markman said, referring to cervical cancer. He explained that cervical cancer, among others, is caused by persistent HPV infection, which is sexually transmitted.
It's recommended that individuals get vaccinated for HPV when they're children; however, because it's a sexually transmitted disease, Markman said people weren't as open to having a conversation about how it affects women and men when the vaccine was first introduced to the market.
"The mistake was saying that [getting the vaccine was meant] to prevent a sexually transmitted disease," Markman explained. "What should have been done is saying that this is simply a cancer-preventing vaccine."
While the vaccine was initially advertised with emphasis on young girls and preventing cervical cancer, Markman adds that vaccinating young boys can also protect them if they're ever exposed to HPV and lower the risk of transferring it to someone else in the future.
Healthcare providers that received Provider Relief Fund (PRF) monies will be assessed on how they billed for out-of-network patients who received treatment for COVID-19.
Healthcare providers and hospitals that received funding from the Provider Relief Fund (PRF) will be audited for their compliance of the balanced billing requirement (or "surprise billing"), a requirement they must follow to receive the funds. The PRF reimburses eligible healthcare providers for related expenses or lost revenue due to COVID-19. The PRF funded $178 billion to providers and hospitals through the CARES Act, Paycheck Protection and Health Care Enhancement Act, and Consolidated Appropriations Act, 2021.
The U.S. Department of Health and Human Services (HHS), Office of Inspector General, plans to conduct a nationwide audit to determine whether hospitals that received PRF funding complied with the billing requirements for COVID patients. This requirement stipulates that those hospitals must not pursue out-of-pocket payments from COVID patients whose bill exceeded "what the patients otherwise would have been required to pay" for in-network care.
"We will assess how bills were calculated for out-of-network patients admitted for COVID-19 treatment, review supporting documentation for compliance, and assess procedural controls and monitoring to ensure compliance with the balance billing requirement," an HHS statement said.
In related news about surprise billing, the Texas Medical Association (TMA) filed a brief yesterday asserting its opposition to a federal ruling that TMA thinks unfairly favors health insurers in situations to resolve payment disputes between payers and physicians via the No Surprises Act. The brief stated that the rule fails to implement the No Surprises Act the way Congress wrote it.
"The last thing federal regulators should do is make health care more expensive and less accessible for people when they need it, especially during a pandemic," E. Linda Villarreal, MD, TMA president said in a statement. "The courts must reject the federal agencies' flawed approach, because it goes against the public interest and our democratic process."
With the omicron surge and possible future variants, it's a matter of stabilizing the number of cases, says one medical director.
As we enter year three of the pandemic, amid the spread of the most infectious variant of the virus, signs could be pointing toward COVID-19 becoming endemic, says one medical director.
According to Dr. Sachin Nagrani, medical director for primary care provider Heal, during a pandemic the number of COVID cases rise and fall across the world at an unstable rate. However, for a virus to become endemic, there needs to be a prevalence of it at an expected level.
"A good example to bring it home for people is that endemic doesn't mean that its constant all the time. You can have [seasonal] variants," Nagrani said.
He noted that while 12,000 to 50,000 individuals die of the flu each year, it's an infectious disease we've come to live with as a society. COVID-19 becoming endemic will depend on the number of cases stabilizing, as well as the progression—or further mutation—of the virus.
The omicron variant has proven to be the most contagious variant of COVID by far, yet with less severe symptoms. As for new variants, Nagrani stated there will be more in the future.
"Viruses are routinely undergoing mutation as they spread around and so there are different strains of it," he said. "Strains are just changes in the DNA or mutation [of the virus]. The way we've been using the word variant is to define a strain that has spread significantly around the population."
While 'deltacron' has been mentioned in recent news as cause for concern, Nagrani explained that it's not a new variant, but rather a popularized term used to describe the infectivity of the current omicron variant and the severity of the delta variant.
COVID-19 becoming endemic is dependent on infections arriving at a stabilized state, which can happen naturally or steadily with the use of preventive measures.
"Preventive measures affect not only COVID, but also other [infectious agents]," Nagrani said, noting that there was a drop in the number of flu cases for the 2019–2020 flu season—right when individuals began taking precautions for COVID. "The trifecta of impacting the virus is preventative measures, testing, and treatments—and preventive measures are generally the most important."
As hospitals everywhere struggle to accommodate the surge of omicron variant COVID cases, healthcare workers are being stretched to their limits while also having an increased risk of getting sick. While the staffing strain is a result of COVID, looking at things from a policy perspective, Nagrani explained how the pandemic seems to have disrupted the systems previously in place.
'We have hospitals that have been traditionally designed, such that you don't have excess capacity. Having extra staff, extra beds—is not a good operating model for a hospital," he said. 'When you see surges like this from public health emergencies, we're not well equipped to handle it. So going forward, what type of public health policies are taken not just from a prevention measure but from a responsiveness measure, will be something that will be interesting to see."
He added while certain measures may not have a fixed cost, like building a bigger hospital, they may be more along the lines of setting up field hospitals and emergency centers that can be easily deployed to areas that need additional assistance.
Editor's note: This story was updated on January 26, 2022.
OSHA withdrew a majority of provisions in its Healthcare Emergency Temporary Standard in December 2021.
OSHA's withdrawal of non-recordkeeping portions in its Healthcare Emergency Temporary Standard (Healthcare ETS) on December 21, 2021, which protected healthcare workers from COVID-19 in healthcare settings, is causing employee safety and worker morale concerns, says Liz Borkowski, senior research scientist at George Washington University’s Department of Health Policy and Management.
Borkowski explains that whenever OSHA adopts a temporary standard, like the Healthcare ETS for healthcare workers last June 2021, six months is then allotted in the OSH Act for the agency to create a permanent standard.
However, OSHA was unable to finalize a final Healthcare ETS rule within the timeframe, stating delays due to the recent surge of COVID-19 variants. OSHA withdrew a majority of provisions in its Healthcare Emergency Temporary Standard in December 2021.
Among the requirements in the Healthcare ETS were the designation of a safety coordinator to monitor compliance with the COVID plan specific to the workplace; limiting and monitoring points of entry to areas where patients are treated; screening patients, visitors, and non-employees for symptoms; and providing and enforcing the use of masks, as well as social distancing.
In its statement announcing its withdrawal of non-recordingkeeping provisions in the Healthcare ETS, OSHA stated it would "vigorously" enforce the general duty clause and its general standards to protect healthcare employees.
"OSHA does not have a standard for every single thing that might appear in a workplace, but the general duty clause basically means that they expect employers to be keeping up on what the hazards in their industry, in their workplace [are], and to have protections for those," Borkowski says.
The enforcement of the general duty clause is, of course, dependent on employers being proactive and evaluating potential hazards (in this case, the possibility of getting COVID), having protective measures in place, and OSHA holding employers accountable through inspections. Yet, with OSHA not having enough inspectors to visit every workplace, Borkowski says there's a possibility some employers could see this as an opportunity to cut corners.
Amid a surge of omicron variant COVID-cases and worsening healthcare staffing crisis, organizations like National Nurses United have pleaded with OSHA to implement a permanent standard and to reimplement the temporary Healthcare ETS, holding a National Day of Action on January 13 to demand the Biden administration take action to protect the nurse workforce.
"Our employers claim there is a 'nursing shortage,' and that's why they must flout optimal isolation times, but we know there are plenty of registered nurses in this country," Zenei Triunfo-Cortez, NNU president, said in a statement. "There is only a shortage of nurses willing to work in the unsafe conditions created by hospital employers and this government's refusal to impose lifesaving standards. So this is a vicious cycle where weakening protections just drives more nurses away from their jobs."
That same day, the U.S. Supreme Court voted in favor of the Biden administration's authority to mandate that all healthcare workers be vaccinated. However, the court also ruled against requiring employees for large businesses to be vaccinated.
"It's always up to the employers to protect [their] employees. They've always had this duty to protect their employees, to have safe and healthy workplaces," Borkowski says. "The difference now is that OSHA—if they're going to be using the general duty clause rather than a specific standard—employers might feel that they have more wiggle room and that they don't have to do quite as much."
Borkowski adds that her hope is that employers, including those outside of the healthcare sector, recognize that keeping their workers healthy is the best way to keep their workers at their organizations.
In a survey by the NNU, 83% of nurses said half their shifts are "unsafely staffed." Sixty-eight percent said they've considered leaving their current position.
With healthcare workers handling the brunt of the stress and strain of the pandemic, Borkowski isn't surprised at the low morale many of them feel.
"People—potential and current healthcare workers—might think twice about entering or staying in a job where they don't feel like they are protected or they don't feel like employers are looking after their health," she says. "If we don’t protect healthcare workers now, not only are many of them going to get sick, but we will have fewer healthcare workers doing these essential jobs into the future."
The court 'halted one of the most effective tools' in gaining control of the virus, the American Medical Association says.
Though the U.S. Supreme Court on Thursday blocked President Biden’s COVID vaccination and testing mandate for large businesses, it did, however, allow the Biden administration to mandate vaccines for most healthcare workers in the United States.
The court voted against the vaccination and testing mandate in a 6-3 ruling. The mandate for healthcare workers will proceed with a 5-4 vote.
In a statement from the White House, Biden said the healthcare worker mandate “will save lives,” and expressed his disappointment at the Supreme Court blocking the mandate for employees.
"As a result of the Court’s decision, it is now up to states and individual employers to determine whether to make their workplaces as safe as possible for employees, and whether their businesses will be safe for consumers during this pandemic by requiring employees to take the simple and effective step of getting vaccinated," Biden said.
Leaders, members, and observers of the healthcare industry have released their own respective statements in response to the ruling.
Dr. Gerald E. Harmon, president of the American Medical Association (AMA), says the Court "halted one of the most effective tools" in gaining control of the virus.
In a statement from the AMA, Harmon said that while he’s pleased with the mandate for healthcare workers, he and the organization are disappointed in the ruling on vaccinations and testing for large businesses, noting the role workplace transmission has played in the spread of the virus.
"The high court’s decision does not contest the reliability of scientific evidence in support of COVID-19 vaccine requirements, and in fact, cites the AMA’s support in upholding the CMS rule," Harmon said. "Widespread use of the COVID-19 vaccines has proven to be the safest, most effective way to reduce the virus transmission and public harm. We continue to urge large employers to do their part to safeguard their workforces and communities so we can defeat this COVID-19 pandemic together."
Commenting on the ruling, Dr. Jeff Levin-Scherz, Willis Towers Watson population health leader, stated that many employers already had mandates in place to protect their employees.
In a statement from Katie Smith Sloan, president and CEO of LeadingAge, a nonprofit provider of aging services, Sloan calls vaccines and boosters the "most powerful tools" to fight COVID.
"While mandates can sometimes make it harder for employers to keep or find qualified workers—especially as Omicron surges and workforce challenges are growing—we encourage all members, regardless of care setting or community type, to ensure staff get vaccinated," Sloan said.
Sloan added that many LeadingAge providers began implementing mandates long before the government announced their plans to do so.Speaking on behalf of the American Hospital Association, president and CEO Rick Pollack emphasized the frustration and exhaustion healthcare workers have faced simply in trying to treat patients throughout the pandemic, saying that the vaccines have been "a ray of light" in that they at least decrease the chances of them getting seriously ill or needing to be hospitalized.
"Now that the Supreme Court ruling has lifted the ban on the CMS vaccine mandate, the AHA will work with the hospital field to find ways to comply that balances that requirement with the need to retain a sufficient workforce to meet the needs of their patients," Pollack said.
Additionally, Pollack said the AHA expects the Biden administration to work with them by providing funding and other resources to "bolster the healthcare workforce."
The Association of American Medical Colleges released a statement applauding the ruling and its recognition of medical community’s support of the vaccine, also noting its disappointment at the mandate for large businesses being blocked.
"The science is unequivocal. COVID-19 vaccines are safe and prevent severe illnesses, hospitalization, and death when dealing with all coronavirus variants," David J. Skorton, AAMC president and CEO, said. "Vaccine requirements help the nation continue to combat the spread of the pandemic. The experience of AAMC member institutions demonstrates than an overwhelming majority of employees get vaccinated after a requirement is instituted, contributing to the health and safety of patients and staff alike."
Centers for Medicare & Medicaid Services Administrator, Chiquita Brooks-LaSure, expressed that the organization was pleased with the Supreme Court's ruling.
"Vaccines are proven to reduce the risk of severe disease. The prevalence of the virus and its ever-evolving variants in healthcare settings continue to increase the risk of staff contracting and transmitting COVID-19, putting their patients, families, and our broader communities at risk," she said. "And healthcare staff being unable to work because of illness or exposure to COVID-19 further strains the healthcare system and limits patient access to safe and essential care."
Prior to the ruling, CMS had already been implementing its own healthcare worker vaccination rule in 25 states and territories that had not been covered by "preliminary injunctions." Brooks-LaSure said the court’s ruling with allow CMS to fully implement them.
Genesis is now part of MercyOne's Partnered Provider Network.
MercyOne and Genesis Health Systems announced that they have entered an agreement for Genesis to join MercyOne' s Partnered Provider Network. The partnership will be positioned as Incirca Health Network powered by MercyOne and Genesis Health. The multiyear agreement hopes to use both organization's expertise in population health and expand value-based healthcare throughout their respective regions in Iowa.
"This partnership will allow us to expand on our work to transform care with a focus on keeping patients well and able to manage chronic conditions before their conditions require additional interventions," Kurt Andersen, MD, chief clinical officer and chief medical officer of Genesis Health System, said in a statement.
Incirca Health Network provides personalized access to healthcare through MercyOne's Partnered Provider Network, involving insurance payers who have value-based contracts with MercyOne.
"Genesis Health System's expertise and commitment to innovation and quality health care aligns nicely with MercyOne's commitment to providing radically convenient care in a patient-centered approach," Bob Ritz, president and CEO of MercyOne, said in a statement. "As Genesis joins our Partnered Provider Network, we leverage the opportunity to expand the ability to deliver great health outcomes for a much larger portion of the state which brings more value to patients and payors."
"Our organizations share a deep commitment to the health of our members, the communities we serve, and furthering value-based care," Derek Novak, president of MercyOne's population health services organization, said. "By combining our strengths in population health and geographies served, we are uniquely positioned to improve health in our communities and reduce the total cost of care."
Langston is the first female in the organization's 87-year history to hold the position of chief information officer.
Earlier this month, Cindy Langston was appointed as senior vice president and chief information officer (CIO) at Excellus BlueCross BlueShield in New York. She is the first woman to hold the role to CIO within the organization.
Langston has three decades of experience in information technology and consulting, having worked for Dow Corning Corporation, and Aon Hewitt among other organizations. While working with a healthcare company 15 years ago, she was drawn to the insurance industry's mission.
"Excellus's is probably one of the best missions around, connecting with the community and connecting with the members," she said.
"Cindy is an experienced and strategic leader with a proven track record of building high-performing teams and delievering results," Jim Reed, CEO and president of Excellus BCBS, said in a statement.
Langston started at Excellus in 2014 as the vice president in information technology. In 2017, Langston was promoted as chief analytics data officer, moving away from her usually IT-centric duties.
As chief information officer, Langston will oversee new technology iniatitives and training for employees, to improve the way they connect with the business and understand its strategy.
"One of my long-term goals is to maintain our great culture. We have a lot of long-term employees who really know our members and know our culture," she said, going on to emphasize the importance of those employees staying up to date with the technology they use.
Her leadership capabilities carry over into her work in the community. Langston actively serves Excellus' surrounding community of Rochester, serving as a board chair of the local YWCA and member of the Women's Leadership Council of the United Way of Greater Rochester and the Finger Lakes. As a mentor and coach to many individuals, Langston emphasizes the importance of respect, often referencing her "Golden Fry" story, based on an unpleasant experience she had at her first job at a fast-food restaurant.
What she understood from that moment was that an employer has the authority to make an employee feel great at work or bad. Carrying that lesson with her, she's always conscientious of the things she does and says to the individuals she's working with.
"Every opportunity I have to speak with a female, especially a person of color, they have my attention, and they have my time," Langston said.
Stockman enters the role with two decades of experience in healthcare management.
Lydia Stockman, RN, MHA, FACHE, is the newly appointed chief administrative officer at Inspira Health for its Mullica Hill and Woodbury medical centers in New Jersey, beginning today.
Stockman will have charge over the two organizations’ overall operations and continue to advance Inspira Health’s work as a high reliability organization.
Previously, she served as the senior vice president of clinical operations at Robert Wood Johnson University Hospital. During her tenure with the hospital, she established the first intermediate care unit for the cardiac service line and elevated their stroke center from primary to comprehensive by recruiting physicians and securing funding for the facility’s neurocritical ICU.
“Lydia brings a wealth of knowledge in hospital management, particularly in strategic planning and growth, operations management, physician and patient satisfaction, and clinical quality and performance, making her a great addition to the Inspira Health team,” Warren E. Moore, executive vice president and COO of Inspira Health said in a statement. “This experience, coupled with working in a high reliability organization, uniquely positions Lydia to innately understand the future of Inspira Health as outlined in our new strategic plan.”
“I am looking forward to leveraging Inspira’s regional presence as a leading health care network in South Jersey and to identify new opportunities for business development and strategic growth, which will attract top physicians and health care professionals to ensure that we provide the highest quality of safety and care to our patients,” Stockman said in a statement. “I am honored to serve Inspira Health in this role and to advance the network’s new strategic plan without ever losing sight of providing a positive environment for all our patients, visitors and employees.”
The facilities will be working together to improve access to care and quality of treatment for the Greater Baton Rouge area.
On January 5, Baton Rouge General Medical Center’s Pennington Cancer Center and Mary Bird Perkins Cancer Center announced their ten-year partnership to improve and increase access to cancer treatments in the Greater Baton Rouge area.
The agreement, which went into immediate effect, allows the two organizations to work together to make cancer care and treatments more accessible, and to create a strong focus on prevention and early detection. While they will still operate independently, they will be sharing technology, working together on clinical trials, and offering options for advanced treatment to patients.
“Baton Rouge General’s commitment to cancer care aligns with Mary Bird Perkins’ mission to improve survivorship and lessen the burden of cancer, so we are excited to be a part of their medical community,” Todd Stevens, president and CEO of Mary Bird Perkins Cancer Center said in a statement. “This is a collaborative relationship that extends existing physical, technological, and professional resources.”
Patients have the option to be treated at either facility, or both, with linked electronic medical records streamlining communication between the two. Through its partnership with OneOncology, Mary Bird Perkins will share its access to clinical trials and EHR with Baton Rouge General.
The infusion clinic recently completed on Baton Rouge General’s Bluebonnet campus as part of the partnership has several amenities available to patients including two private infusion rooms in addition to 36 infusion bays and heated chairs. There’s also an infusion center pharmacy inside the facility to expedite treatment.
“We know that your world changes when you receive a cancer diagnosis,” Edgardo Tenreiro, president and CEO of Baton Rouge General, said. “We want patients to feel comforted and confident in knowing that they can receive care and support from Baton Rouge’s two most preferred cancer centers, in a seamless, comprehensive, and compassionate way, right here, close to home.”
