All too often, those decisions conflict with the recommendations of the patient s health care provider. As the primary consumers of and decision-makers about health care for their families, women are most likely to be involved in appealing denials of care. Plans must have an appeals procedure that is quick and easy, and gives patients the opportunity to be heard by independent experts who can review the plan s decision according to the best scientific evidence available. Plans should be bound by the recommendations of these independent experts. Providers trained specifically to meet women's health care needs.
Many providers still practice medicine based on the traditional male model of biology and disease.
Health plans can play a pivotal role in advancing the practice of gender-based medicine, and they should make sure women have access to both primary care and specialty providers who are trained to meet their particular health care needs. Health plans use rules known as clinical practice guidelines to direct providers in selecting treatments and to help plans determine what treatments or services to cover. The plan's clinical practice guidelines should be developed by knowledgeable experts and specialty groups, not the plan's accountants. Quality improvement systems that address women's health issues. Good health plans should continuously evaluate and strive to improve the quality of care they deliver, and they should make sure the conditions and diseases that affect women are included in what they monitor.