Partnership for Prevention and ACPM commend expanded coverage of preventive services under Medicare

07/29/04

Washington, DC Partnership for Prevention, a nonprofit organization devoted to helping Americans prevent disease and injury, welcomes new proposed rules from the Department of Health and Human Services to expand coverage for preventive services under Medicare as "a step in the right direction." The proposed rules were also well received by the American College of Preventive Medicine, the professional society of physicians who specialize in preventive medicine.

Under proposed rules announced Tuesday, in 2005 Medicare will begin covering initial comprehensive physical examinations for new Medicare beneficiaries and will expand coverage for cardiovascular and diabetes screening. Previous legislation expanded Medicare coverage for a number of cancer screening tests, immunizations, and other preventive services proven to save lives and improve the health of seniors.

"Prevention is common sense, and it's good policy," said Jonathan E. Fielding, MD, MPH, MBA, chair of Partnership for Prevention. "Chronic diseases that afflict millions of Americans and drive up the cost of health care can be reduced in incidence and severity by evidence-based preventive measures. The more Medicare covers preventive services that have been proven to save lives, the better for the health of beneficiaries and the better for taxpayers. This new provision is an important step in a longer, overdue journey to modernize preventive care for America's seniors."

Coverage of a comprehensive clinical evaluation as beneficiaries enter the Medicare program, as proposed under the new rules, provides an opportunity for physicians to identify and address health habits, such as smoking, physical inactivity and poor nutrition, which are the leading underlying causes of death in the United States. The proposed rules would cover education, counseling, and referrals regarding these risk factors and other issues identified during the comprehensive clinical assessment. The visit would also be used by doctors to administer screening tests and immunizations or to make arrangements for their delivery at a later date.

"The Welcome to Medicare visit is an opportunity to start seniors off on the right foot," said Robert Harmon, MD, MPH, president of the American College of Preventive Medicine. "It's a chance to remind beneficiaries that adopting a healthy lifestyle can prevent disease, rather than later facing the pain, suffering and expense of advanced disease."

Not all preventive services recommended by expert panels are covered under the proposed Medicare rules. Both Partnership for Prevention and the American College of Preventive Medicine plan to examine the proposed rules more closely and provide detailed responses to the Department of Health and Human Services.

"Our work is not done," said Steven H. Woolf, MD, MPH, Partnership executive vice president for policy development. "The initial visit is a moment in time, but prevention is a continuum. We will continue to work with the Medicare program to make further improvements in the quality of preventive care offered to America's seniors."

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Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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