Jun 20, 2011

Prevention Just Makes Sense

By Don Berwick, Administrator, Centers for Medicare & Medicaid Services

“Prevention” is a word we use a lot in health care – June is “National Prevention and Wellness Month” – but I want to take a minute to think about what it really means.

Intuitively, prevention makes sense: as the saying goes, you can either pay now or you can pay later. But oddly enough, our health care system often doesn’t reflect this fundamental mindset. Most health care focuses on treating disease. Prevention, on the other hand, focuses on health.

Preventive care is also patient-centered care, as people become active participants in maintaining their health and get services customized for their individual needs and preferences.

We know that prevention works. The Affordable Care Act provides new ways to help patients stay healthy and makes access to preventive services easier.

Today, the Centers for Medicare and Medicaid Services (CMS) released a new report showing that more than 5 million Americans with traditional Medicare, or nearly one in six people with Medicare, took advantage of one or more of the recommended preventive benefits now available for free thanks to the Affordable Care Act – most prominently, mammograms, bone density screenings, and screenings for prostate cancer.

These are just a few of the preventive services available to people on Medicare. Earlier this year, Medicare eliminated the Part B deductible and copayments for a host of preventive services, including bone mass measurement, some cancer screenings, diabetes and cholesterol tests, and flu, pneumonia, and hepatitis B shots.

We’ve also eliminated out-of-pocket costs for the “Welcome to Medicare” preventive visit and, for the first time since the Medicare program was created in 1965, Medicare now covers an annual wellness visit with a participating doctor, also at no cost.

We’ve added expanded prescription drug benefits to the preventive arsenal as well. This year, people with Medicare started to benefit from a 50% percent discount on covered brand name drugs bought when they’re in the donut hole, and we’ll continue to chip away at the donut hole until it’s closed in 2020. Making prescription drugs more affordable increases the chance they’ll be taken as needed. Again – prevention just makes sense.

Find out which preventive services are right for you by taking this checklist [PDF, 101 KB] to your doctor or other health care provider.

Our job now is to ensure that everyone eligible for Medicare uses these benefits. We need to encourage every person with Medicare, every caregiver, every physician to join our nationwide campaign for prevention. We are calling our campaign, Share the News, Share the Health, which will run throughout the summer, with online ads and community events all over the country starting in July.

Focusing on prevention doesn’t just improve care – it’s also an important step in reducing the cost of health care. The financial costs of treating chronic diseases like heart disease, cancer and diabetes are enormous. Add in the intangible costs of pain and suffering, and the very real economic costs of lost productivity, and the opportunity costs of chronic illness are simply unacceptable.

This is why we’re also working closely to incorporate best practices from the Centers for Disease Control, particularly around ways to reduce cardiovascular mortality. This type of collaboration is critical to moving us towards a prevention-based model of care.

Focusing on prevention also makes sense when we value treating the whole patient – not just a condition or disease. When we help people take better care of their health, everyone in the community benefits. If we wait to pay for care as illness progresses, the price of health care for the country will continue to rise.

Prevention just makes sense.