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Health care reform can help align preventive care recommendations with Medicare coverage
Date:1/17/2011

Health care reform should be able to mend a disconnect that has existed between the recommendations of the U.S. Preventive Services Task Force (USPSTF), a task force charged by the government to review clinical preventive health services for older adults, and Medicare coverage for those services, a new UCLA-led study finds.

In particular, there is a need to improve coordination between assessing the risk for certain illnesses and ensuring the patient receives the appropriate tests and follow-up medical services, according to the study, which is published in the January/February issue of the Annals of Family Medicine. Alarmingly, there also continues to be a lack of coverage for obesity and nutritional services, both of which are supported by the task force and important for maintaining good health.

Prior to January 2011, Medicare covered one preventive health visit, the Welcome to Medicare Visit (WMV), within the first year. Reimbursement for this visit comprised the majority of coverage for preventive coordination under Medicare but has been largely underutilized with only 6 percent of beneficiaries actually receiving a WMV. The health care reform law expanded coverage to an annual wellness visit covering several aspects of prevention, including an assessment of risk for disease and developing a personalized prevention plan.

"By expanding coverage for the preventive health visit, the health care reform law provides avenues to align Medicare payments with the recommendations of the USPSTF, and for better coordination between screenings and clinical services, said Dr. Lenard Lesser, a family physician and researcher with the Robert Wood Johnson Foundation Clinical Scholars at UCLA and the study's lead author. "For these reforms to be effective, however, Medicare beneficiaries must take advantage of the expanded coverage and get their annual check-ups."

The study authors conclude that although the health care reform
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Contact: Enrique Rivero
erivero@mednet.ucla.edu
310-794-2273
University of California - Los Angeles
Source:Eurekalert

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