Issue #136  ·  March 16, 2026

The Skill Most Women's Health Professionals Were Never Taught

The Business of Women's Health

The Skill Most Women's Health Professionals Were Never Taught

Reimbursement is the operating system of healthcare. Most of us were never taught how to speak it — and that gap is quietly shaping who advances in women's health and whose work stalls out.

I have spent over a decade building in women's health — convening the first Women's Health Reimbursement Summit, and sitting inside rooms with the clinicians, operators, and founders trying to make this system work better for women.

And I will be honest with you: it took me far longer than it should have to truly understand how reimbursement worked.

Not for lack of caring. Not for lack of proximity to people who live inside it. But because nobody in this industry teaches it systematically — not in medical school, not in MBA programs, not in fellowships or onboarding decks or strategy off-sites. You figure it out by running into walls, or you stay in the dark.

Building the first Reimbursement Summit, I sat with clinicians who had tried and failed to stand up menopause service lines, operators who had watched pelvic floor programs quietly collapse, and policy advocates who had been fighting the same structural battles for a decade. Every single conversation came back to the same sentence: I didn't learn this anywhere. I figured it out the hard way.

So this year, we ran a quiz. Ten questions, sent to a community of active women's health professionals — operators, clinicians, strategists, founders. The average score was 6 out of 10. And the pattern in the wrong answers confirmed exactly what those conversations had told me.

People understand the principles. What they can't name is who is actually making the decisions — and how.

The Committee Most People in Women's Health Have Never Heard Of

Here's the thing I say at dinners that makes people put down their forks: the single most powerful committee in women's health isn't a women's health committee at all.

It's the RUC — the AMA/Specialty Society Relative Value Scale Update Committee. A 32-member panel that recommends to Medicare how much cognitive and procedural work is worth. Those recommendations set the rates. The rates shape what services are viable. And for most of its history, women's health specialties have been dramatically underrepresented in that room.

That's not a conspiracy. It's just how the infrastructure was built — and it's why pelvic floor care and perimenopause management keep hitting the same wall. The science advances. The demand grows. The payment rates don't move — because the people who set them aren't being pushed to move them.

Coverage Without Viability Is a Policy Fig Leaf

I've been in rooms where someone announces that a new women's health service is now "covered" — and the room cheers. I've learned to ask the follow-up question: covered at what rate?

Coverage means a service appears in a payer's benefit design. Reimbursement means a provider actually gets paid enough to offer it sustainably. A service can be covered and completely unavailable — because no practice can afford to staff it.

This is the gap that's killing pelvic floor programs and menopause service lines. Not lack of awareness. Not lack of demand. The reimbursement rate for a 45-minute pelvic floor evaluation is often lower than a 15-minute procedure that requires a fraction of the clinical skill. That's not an accident — it's an output of a valuation process that has historically underweighted cognitive, longitudinal, relationship-based care. Which is, not coincidentally, most of women's health.

What Building the Summit Taught Me

When I started building the Women's Health Reimbursement Summit, I spent months talking to the people who actually operate inside this system — clinicians who've tried to build menopause programs, operators who've watched service lines collapse, policy advocates who've sat in the RUC comment process. The thing they all said, in different words, was the same: I didn't learn this anywhere. I figured it out by running into walls.

That's the gap I'm trying to close. Not with a lecture on billing codes — but with a clear map of how the system actually works, who holds the levers, and what questions to ask before you build something that the payment architecture will quietly undermine.

The four questions I'd want every operator, clinician, and strategist in women's health to be able to answer:

If you can answer all four, you're operating at a level most people in women's health never reach. If you can't — that's not a personal failure. It's a structural one. Nobody taught us this.

A Place to Go Deeper

The Summit is my attempt to give people the map I wish I'd had earlier. Not a certification. Not a billing course. A room full of people who are done running into the same walls — and a framework for finally understanding why those walls exist.

Across the program, we'll cover how services actually get valued and covered, how committees and coding decisions shape what's sustainable versus what burns people out, and how to map reimbursement pathways for the specific programs you're building or advising on.

One Thing This Week

This vs. That

Covered vs. Viable

Training yourself to always ask "Is this covered and viable?" turns vague advocacy into concrete business decisions — and is one of the fastest ways to start thinking like an operator in women's health.

By the Numbers

On the Radar — Events

This Week's Full Job List

100+ Open Roles  ·  20+ Companies

Clinical  ·  Commercial  ·  Ops  ·  Product  ·  Senior & C-Level  ·  International

The people who understand both care and reimbursement quietly shape what gets built in women's health. If someone in your network should be in that group, forward this issue to them.