Investigators with the Partnership for Prevention conducted a series of surveys and focus groups with employers to determine to what extent employer-sponsored health insurance plans offer coverage for clinical preventive services—including immunizations, screening tests and health behavior change counseling—or promote their use.
Investigators conducted an initial survey of 3,156 employers to establish baseline statistics and several follow-up surveys and focus groups to better understand the factors that employers weigh in making their benefits decisions.
More than 90 percent of surveyed employers cited increased productivity and decreased health care costs among their most important reasons for covering clinical preventive services.
Within employer-sponsored health insurance, more than 50 percent of plans covered physical examinations, immunizations and screenings.
Some 20 percent of plans covered tobacco cessation interventions (e.g., counseling and/or medication), and 18 percent covered screening, counseling and medical therapy for alcohol problem prevention.
HMOs were only moderately more likely than other types of health plans to provide coverage for clinical preventive services.
Employers should work with their health plans to ensure that they are covering the most beneficial package of preventive services.
Health researchers, health plans and benefit consultants should ensure that existing return-on-investment information on preventive services reaches employers in a useful format.
State legislators and governors can refine mandates by working with health plans, major employers and state regulators to guarantee that preventive services recommended by the U.S. Preventive Services Task Force are offered and provided to all covered individuals in all health plan types.