Affordable Care Act to the Rescue?

Study shows healthcare reform can help align Medicare coverage with government task force recommendations

(RxWiki News) A recent study finds that a disconnect between Medicare coverage for preventive services and a task force charged with reviewing those services for older adults can be mended by healthcare reform.

The study from the University of California, Los Angeles, finds that improved coordination between illness risk-assessment and ensuring that patients receive appropriate tests and follow-ups is needed as part of the effort to align Medicare coverage with recommendations from the U.S. Preventive Services Task Force (USPSTF).

There should also be more coverage for obesity and nutritional services, according to the report.

The Patient Protection and Affordable Care Act (PPACA) (aka the recently enacted health reform act) manates that the one preventive/wellness health visit that was previously allowed by Medicare is now allowed once per year instead of just once in a peron's lifettime. These visits include a risk assessment for disease as they aim to develop personalized prevention plans for patients.

The responsibility doesn't exclusively lie with Medicare, however.

For these reforms to be effective, Medicare beneficiaries need take advantage of th isexpanded coverage by actually going and getting these preventive/wellness check-ups, said Dr. Lenard Lesser, researcher with the Robert Wood Johnson Foundation Clinical Scholars at UCLA and lead study author.

Researchers found that Medicare fully covered only one of the USPSTF's recommended preventive interventions -- screening for abdominal aortic aneurysms -- while other recommended preventive measures were only partially funded, including screenings for cervical cancer, colon cancer, hypertension, lipid disorders, tobacco and alcohol use, depression, breast cancer mammographies, diabetes and obesity, among others.

The study concludes that the charge lies with Medicare officials to align payments with USPSTF recommendations. Lesser said expanding coverage for wellness and preventive visits is one way the PPACA can be effective.

Review Date: 
January 18, 2011