A paradigm shift has occurred in health care, resulting in a renewed emphasis on prevention. To reap the benefits of prevention, both health care providers and health care consumers must first understand what those benefits are. The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 (Public Law 108-173) expanded Medicare’s menu of preventive benefits by covering an initial preventive physical examination. This benefit, also referred to as the “Welcome to Medicare” visit, allows new Medicare beneficiaries to get up-to-date information on important screenings and vaccinations, as well as to talk with their health care provider about their medical history and how to stay healthy. All beneficiaries enrolled in Medicare Part B with effective dates that begin on or after January 1, 2005, will be covered for this benefit.
The Welcome to Medicare visit enables the health care provider to provide a comprehensive review of his or her patient’s health, to identify risk factors that may be associated with various diseases, and to detect diseases early when outcomes are best. The health care provider is also able to educate his or her patient about the Medicare-covered services they need in order to prevent, detect, and manage disease; to counsel them on identified risk factors and possible lifestyle changes that could have a positive impact on their health; and to make referrals or followup appointments for necessary care. CMS will continue to support and conduct outreach related to the Welcome to Medicare benefit to increase beneficiaries’ utilization.
Although Medicare pays for many critical preventive screenings, fewer than 1 in 10 adults aged 65 or older receive all recommended screenings and immunizations. CDC’s Healthy Aging Program will continue to support a model program, Sickness Prevention Achieved through Regional Collaboration (SPARC), which has shown significant success in broadening the use of preventive services. SPARC promotes public access to services, helps medical practices provide preventive services, and strengthens local accountability for service delivery.
AHRQ accomplishes adoption and delivery of evidence-based clinical prevention services to improve the health of Americans through two main avenues: work in support of the United States Preventive Services Task Force (USPSTF) and Prevention Portfolio efforts aimed at dissemination and implementation of the Task Force’s recommendations. As the USPSTF makes evidence-based recommendations, it is the job of AHRQ to get the word out to clinicians and the general public as rapidly as possible. Accomplishing this goal more quickly puts actionable information into the hands of clinicians, guiding them to perform indicated services and not to perform services for which the evidence indicates more harm than benefit. Getting the word out increases the delivery of appropriate clinical preventive services. Clinicians and policymakers across the Nation hold the work of the USPSTF in high regard.
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