Women receive substantial preventive care services in OB-GYN and women’s health clinic settings. Through the Women’s Health Initiative, women’s health specialty providers are providing enhanced health and psychosocial screening along with comprehensive family planning counseling and timely access to long acting reversible contraception (LARC). New staff, training, and payments support effective follow-up to provider screenings through brief, in-office intervention and referral to services for mental health, substance use disorder, trauma, partner violence, food and housing. Since launch, the Women's Health Initiative has expanded to included Blueprint Patient Centered Medical Homes.
The Women’s Health Initiative helps ensure that women’s health providers, Patient Centered Medical Homes, and community partners have the resources they need to help women be well, avoid unintended pregnancies, and build thriving families.
Healthier Women, Children, and Families
A few key supports can help Women's Health providers and Patient Centered Medical Homes be even more effective in providing preventive care, identifying health and social risks, connecting women to community supports, and helping ensure more pregnancies are intentional.
Currently in Vermont, half of all pregnancies are unintended. Unintended pregnancies are associated with increased risk of poor health outcomes for mothers and babies and long-term negative consequences for the health and wellbeing of the children and adults those babies become.
The Healthy Vermonters 2020 goal for pregnancy intention is 65%.
Enhanced Screening and Community Connections
The Women's Health Initiative supports practices in building enhanced screenings into regular women’s health visits. Women identified as at-risk in the areas of mental health, substance use disorder, partner violence, or access to food and housing are immediately connected to an initiative-funded social worker for brief intervention and counseling and referral to more intensive treatment as needed. Each social worker is a member of the Community Health Team and available to connect women with the local network of health, social, economic and community service providers.
Same-Day Access to Effective Birth Control
Participating practices offer comprehensive family planning counseling. Women who tell their providers they do not want to have a baby in the coming year have access to all contraception options including immediate access to LARC. Women who wish to become pregnant receive pre-conception counseling and services to support healthy pregnancies.
Building Community Referrals
Each participating Women’s Health Practice develops agreements with at least 3 community-based organizations to see their referred patients within one week, however long their waitlist for new patients may be. This helps ensure that women most at-risk of unintended pregnancy have fast access to effective contraception. Each participating Women’s Health Practice also makes at least 3 agreements with primary care practices to accept patients who don't have a primary care provider.
Women’s Health Initiative Payments for Enhanced Screening and Care
The Women's Health Initiative payments are part of the move from fee-for-service to funding for high quality care. Three payments support Women’s Health practices in the additional training and work and new workflows that are part of the Initiative.
- Per-Practice Per-Person Per-Month Payment – supporting enhanced care, screening, and collaboration with the Community Health Team and community-based organizations
- Community Health Team Payment – Supports 1 full time equivalent mental health clinician per every 1200 attributed beneficiaries, for brief intervention and referral
- Capacity Payment – one-time initial funding to help practices cover the costs of initially implementing the program including stocking LARC
Participating primary care practices that are already Blueprint Patient Centered Medical Homes are also eligible to participate and receive the one-time capacity payment, and - beginning begininng October 1, 2017 - the per-practice per-person per-month payment.