An Ounce of Prevention
http://www.offthechartsblog.org/an-ounce-of-prevention/
Posted by: Sarah Lueck
Posted in: Health Policy, Health Reform, Insurance Coverage
Millions of Americans will soon be able to receive preventive health care services free of charge under rules the White House issued yesterday to help implement the health reform law. The new rules will likely mean fewer unnecessary deaths from diseases like cancer and diabetes, reduced spending on costly and avoidable illnesses, and a healthier population overall.
Many preventive services — from colonoscopies to screenings for cervical cancer — are underutilized, studies show, and the out-of-pocket costs that people must pay for these services under their insurance plans are one reason why.
Under the new rules, insurers will have to provide services such as screenings for chronic illnesses (including diabetes and cancer), routine vaccines for adults and children, and other recommended care for children, such as regular doctor visits.
Better access to preventive care should produce better health outcomes and fewer absences from work and school due to illness. Research also shows that some preventive services reduce health costs over time. An example is pediatric immunization, which helps avert childhood illnesses.
The Administration estimates that about 31 million people will be enrolled in employer-sponsored health plans subject to the new rules in 2011. At least 10 million additional people will have policies purchased in the individual market that are subject to the rules.
In order to help people keep the coverage they had at the time of health reform’s enactment, the rules do not apply to plans that are considered “grandfathered” because they existed on March 23, 2010 and have not been changed significantly. The rules also do not apply to Medicare and Medicaid, which have their own, separate requirements related to preventive services.
More About Sarah Lueck
Lueck joined the Center in November 2008 as a Senior Policy Analyst.
Full bio | Blog Archive | Research archive at CBPP.org
Thanks for your questions. It is true that the change to preventive services is expected to lead more patients to seek the care and procedures that now will be covered more favorably. That means higher costs in some cases. The rule does not estimate the magnitude of such additional costs. It also doesn’t estimate the amount of overall health care savings that would result from the expected reduction in severity of illness, prevention of disease, and increased productivity.
But some of the services covered by the rule have been shown to save more money than they cost. In addition to childhood immunizations, other examples cited in the rule are health care providers discussing aspirin use with adults at high-risk for cardiovascular disease and screening for tobacco use and providing a brief intervention with smokers. In addition, it is expected that increased access to obesity screening and referrals to weight-loss counseling will help bring down a substantial driver of high health costs.
Can you provide more examples of research or studies showing prevention measures (other than vaccinations) will produce savings? I wonder if more costly prevention screens, such as colonoscopies that cost several hundred dollars each, will yield savings over the long term. Thanks, Charles
Is there a cost savings estimate? I don’t remember seeing one. As you note, there are two reasons for making these tests more widely available: human decency / social obligation and cost savings over time. Is there info on the latter?