IOM Releases Report Seen As Possible Harbinger of Essential Benefits Package

The Institute of Medicine (IOM) has delivered their report on preventive services for women’s health to the Department of Health and Human Services (HHS).  The report lays out specific recommendations on what the IOM feels should be covered in health plans in the United States.  Specific recommendations include:

  • Screening for gestational diabetes
  • HPV testing as part of cervical cancer screening for women over 30
  • Counseling on sexually transmitted infections
  • Counseling and screening for HIV
  • Contraceptive methods and counseling to prevent unintended pregnancies
  • Lactation counseling and equipment to promote breast-feeding
  • Screening and counseling to detect and prevent interpersonal and domestic violence
  • Yearly well-woman preventive care visits to obtain recommended preventive services

Significant opposition is likely on the contraception recommendations, if not the entire package as a whole, but the release could illustrate the IOM’s willingness to be specific in other recommendations to HHS moving forward.

Why is this important to O&P?  The specificity of the recommendations is what makes this story newsworthy for the O&P community. The IOM is currently formulating their recommendations to HHS on the “essential health benefits package” as part of the Affordable Care Act.  The essential benefits package will make up the minimum insurance plan that can be sold on “state based health exchanges”.  The state based exchanges are a key element of the federal health care overhaul law — an estimated 11.5 million people are expected to use them in 2014, growing to 27 million by 2018, to comparison shop for coverage.  Inclusion of orthotics and prosthetics in the essential health benefits package is very important to the future of the O&P profession.

The IOM’s willingness to be specific is seen by many as a harbinger of their upcoming recommendations concerning the essential benefits package and a positive step for the future of O&P coverage in the United States.

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