Cost Analysis Shows the Benefits of Disease Prevention Efforts Under Medicare

Advancing the debate on disease prevention and health promotion policy under Medicare

    • January 16, 2005

From July 2001 to the end of 2003, project staff with the Partnership for Prevention, Washington, produced nonpartisan and objective analyses of approaches to increase the emphasis on disease prevention and health promotion under Medicare.

Staff members anticipated that this project would be the beginning of an effort to build knowledge and support for greater emphasis on prevention for Medicare beneficiaries.

However, with the unanticipated passage of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (a bill containing several provisions concerning health promotion and disease prevention), the project staff members shifted their focus to ensuring that their recommendations were heard by officials at the U.S. Department of Health and Human Services in charge of implementing the law.

Key Recommendations

  • In an article published in the American Journal of Preventive Medicine in May 2004, and in the final report to RWJF, project staff offered the following recommendations for the implementation of the Medicare Modernization Act of 2003:

    • Use the initial exam known as the Welcome to Medicare Visit to empower individuals at a moment when they may be ready to establish new health habits and patterns of care.
    • Use the Welcome to Medicare Visit as an opportunity to collect data on the health status and practice patterns of Medicare enrollees to determine the effects of the initial physical exam.
    • Use implementation of the new legislation as an opportunity to build stronger collaboration and coordination on health promotion and disease prevention for older adults across U.S. Department of Health and Human Services agencies.
    • Examine opportunities to expand the "chronic care improvement program," a new benefit for certain chronically ill Medicare beneficiaries, to include ongoing health management.
    • Direct the federal Centers for Medicare & Medicaid Services to develop a Medicare benefit for the tobacco cessation counseling and drug treatments that the U.S. Public Health Service guidelines have identified as effective.