Supporting Women’s Health

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Supporting Women’s Health

05/16/2024

Inviting Doulas to Join Our Networks

EmblemHealth is now inviting doulas to join our provider networks. EmblemHealth will cover doula services in hospital, clinic, and community settings for Medicaid, Health and Recovery Plan (HARP), and Essential Plan members who are pregnant, birthing, and postpartum (for up to 12 months after the delivery date) beginning Jan. 1, 2025 (delayed from Oct. 1. 2024).

If you know a doula who may be interested in partnering with EmblemHealth, please contact medicaidproduct@emblemhealth.com.

For more information on doula reimbursement rates and member benefits, see the article posted in the provider hubs for State-Sponsored Programs and Commercial Networks and Benefit Plans.

Doulas must be enrolled as New York State Medicaid fee-for-service providers.


EmblemHealth Works With SimpliFed to Support New Mothers

SimpliFed, a leader in lactation support, is now an in-network provider with EmblemHealth. This unique maternal health platform offers a bundled, baby-feeding care plan for each patient.

Starting at 28 weeks and continuing well into postpartum, all appointments are done virtually through a secure, easy-to-use portal. SimpliFed offers care in multiple languages and 24/7 support from care navigators or “allies.” And with a simple bi-directional referral process, SimpliFed reduces clinic and provider burden while increasing patient engagement, utilization, and outcomes. 

This emphasis on nurtured, cyclical care has had impressive results: 

  • 87% of SimpliFed patients feed with breast milk for at least three months (national average is 69%).
  • SimpliFed providers have received a 96% patient satisfaction score.
  • 2% no-show rate for all appointments.

For more information on how to refer your commercial, Medicaid, and HARP patients, email contactus@simplifed.us or visit simplifed.com


Elektra Health Can Help Members Through Menopause

Menopause is a process that can take place over several years and usually happens to a woman in her 40s and 50s, mostly between the ages of 45 and 55. It can have mild to severe physical and emotional symptoms that can impact a wide range of daily life experiences and relationships. 0

To help members with their journey from perimenopause through postmenopause, EmblemHealth and ConnectiCare’s provider networks now include Elektra Health, a specialized women’s health virtual care and education provider. They offer valuable information and expertise for managing menopause, which can supplement the care you give your patients.

Take advantage of Elektra Health to help your patients.

Telehealth visits

You may send your EmblemHealth and ConnectiCare members to Elektra Health for telehealth visits without a referral or preauthorization. Elektra Health’s board-certified health care providers are certified by The Menopause Society (formerly The North American Menopause Society). They can order labs and write prescriptions for hormonal and non-hormonal treatments and evidence-backed supplements. The member’s normal cost-sharing for in-network specialist visits under their health insurance plan will apply.

Educational materials

Elektra’s website has evidence-based articles and recommendations on symptoms, hormone replacement therapy, and more. One key resource we recommend sharing with your patients is Elektra’s menopause guide.

Other services

Elektra offers other services that are not covered by our plans but may be of interest to your patients.


Management Is Key: Osteoporosis and Treating Women After a Fracture

Managing osteoporosis is an important part of delivering needed care to our older members. Be sure to assess women 67 – 85 years of age who suffered a fracture and recommend to them a bone mineral density (BMD) test or a prescription for a drug to treat osteoporosis in the six months after the fracture. This is also a key quality measure under the Healthcare Effectiveness Data and Information Set (HEDIS®).

There are several exclusions:

  • Patients who had a BMD test during the 730 days (24 months) prior to the episode.
  • Patients who had a claim/encounter for osteoporosis therapy during the 365 days (12 months) prior to the episode.
  • Patients who received a dispensed prescription or had an active prescription to treat osteoporosis during the 12 months prior to the episode.

Helpful tips to close gaps in care:

  • Ask all female patients 67 – 85 years of age if they have had a fracture since their last visit.
  • Consider writing a prescription for a BMD test at time of fracture.
  • If patients are unable or unwilling to have a BMD test, prescribe osteoporosis medications if appropriate.
  • Place a reminder in the patient’s chart for a BMD test.
  • Partner with your EmblemHealth team to offer in home BMD screening assessments. If you do not already have a contact, please email us at quality_providerengagement@emblemhealth.com.
  • Use telehealth visits to review, document, and prescribe medication, when appropriate.
  • Educate patients on safety and fall prevention.
Provider Update