Dr. Charlotte Yeh has learned firsthand about the importance of preventive care for seniors. Her father, Charles, now 77, read an article that said people his age should have colonoscopies, so he talked to his doctor and underwent the screening.
He was found to have a precancerous lesion, which was successfully removed. “And my father’s still with me,” Dr. Yeh said, “lifting weights, healthy as a horse.”
Yeh, the Boston regional administrator for the U.S. Centers for Medicare & Medicaid Services, told her father’s story as part of the launch of “A Healthier U.S. Starts Here,” a national campaign to educate older Americans about the importance of preventive care – from flu shots, to cancer screenings.
The new campaign, which will include a 48-state bus tour, print and Web materials, new scripts for 1-800-Medicare, and outreach efforts coordinated with state and local partners, was launched in Rhode Island because the state is a leader in health promotion, officials said.
Rhode Island also worked successfully with CMS on the 2005-06 Medicare Part D launch, which led to 90 percent of Medicare beneficiaries nationwide having drug coverage through Part D or another source, according to CMS.
The goal now is to ensure seniors are just as aware of Medicare’s preventive care benefits and take advantage of them. Currently, Yeh said, only 10 percent of seniors take advantage of all the preventive benefits they could get, and many miss out on even the basics: Only 50 percent get basic colorectal cancer screenings annually, for example, and only one-third get bone mass screenings, even though osteoporosis leads to countless bone breaks each year.
“We have coverage out there, and the seniors don’t know about it,” Yeh said. “We spend $1 billion a day on Medicare health services, and 95 percent of that is … for treatment of disease.”
CMS has been working to change that. Last year it added a new “Welcome to Medicare” physical exam benefit, and also last assessment of last year, it launched a new incentive program for doctors, offering up to a 1.5-percent bonus if they report their performance to CMS on several quality measures – including whether patients get thorough preventive care.
Assistant U.S. Health & Human Services Director John O. Agwunobi, a pediatrician and former Florida health director, said people over 65 “typically do utilize health care services frequently,” so they have plenty of contact with health care providers, but it’s mostly for treatment.
Doctors, he said, tell CMS that “they don’t think that they have the time in their offices [and] they don’t get paid” for preventive care, especially such things as smoking cessation advice. But even as CMS works to change that, he said, and to ensure both patients and doctors understand what is covered, it wants to get consumers to “demand preventive services.”
An informational flyer created as part of the Healthier US campaign includes a checklist that seniors can use, with a list of all available preventive benefits and an explanation of “what it does” and how often you can get the service under Medicare. The idea is that patients will take the list into the doctor’s office and talk about which screenings, immunizations, etc. that they should get. If they sign up at www.MyMedicare.gov, they can also track the preventive benefits they’ve used each year and get reminders of other benefits.
Local efforts will build on the campaign. Rhode Island, for example, will do its own outreach, Gov. Donald L. Carcieri said, including possible “screening days” at senior centers. And Dr. David R. Gifford, the state health director, noted at a roundtable discussion earlier that the state had partnered with CMS to be prepaid for flu vaccines this year, so providers will be able to get an ample supply without worrying about reimbursements.
Agwunobi also said the Healthier U.S. campaign is emblematic of a broader vision for health care in the United States.
“We’re looking for a cultural change across the nation,” he said. “We’re looking for an ethic of prevention.”
