The researchers sought to examine how well the task force's recommendations were aligned with Medicare coverage before implementation of health care reform. They looked at the services that USPSTF recommended (these have an A- or B-rating) as well as those the task force did not recommend (D-rated). They then divided Medicare coverage for those services into two delivery components: preventive coordination, which includes risk assessment and arranging for appropriate services, and the preventive service itself, which includes the actual testing as well as counseling.
Services rated A by the USPSTF for adults over the age of 65 include screenings for cervical cancer, colon cancer, high blood pressure, lipid disorders for men and for women (each listed separately), and tobacco use. B-rated services comprise screenings for abdominal aortic aneurysm, alcohol (counseling also included), breast cancer genetic risk, depression, diabetes, obesity (also counseling), and osteoporosis as well as breast cancer mammographies and counseling for a healthy diet.
The researchers found that of the 15 recommended preventive interventions for these older adults, only one--abdominal aortic aneurysmswas fully covered by Medicare for both coordination and service. Most of the rest received either partial funding on one side and full on the other, or only partial funding for each. For instance, osteoporosis services (i.e. getting a bone density scan) were fully funded while risk assessment and other elements of coordination were only partially funded, and depression services and coordination each got only partia
|Contact: Enrique Rivero|
University of California - Los Angeles