Medicare Preventive Services: A Vital Component of Chronic Care Management (99490)

In June, the Centers for Disease Control and Prevention (CDC) released their 1999-2014 statistics on Cancer Incidence and Mortality. Once again, breast and prostate cancers topped the charts. The good news is that early detection is driving survival rates up.(1) In order to keep this positive health trend going up, Medicare patients need to take advantage of Medicare Preventive Services. Preventive medicine is important to these vulnerable populations, especially people with chronic conditions. Studies show that Chronic Care Management (CCM), like that offered by CareHarmony, increases adherence to preventive measures, such as cancer screenings.⁽²⁾ CareHarmony provides patients with the support they need to utilize Medicare Preventive Services and protect their health.

More than Prevention: How Preventive Medicine Works

Preventive medicine is many faceted and encompasses a wide-variety of programs and specialties. The aim of these efforts is twofold. One is to reduce the incidence of disease, or primary prevention. The second is early diagnosis and treatment, or secondary prevention. While most people associate preventive medicine with the vaccines of childhood, it plays a large role in healthcare for adults, as well. According to the CDC, screenings and early treatment leads to better quality of life and lower healthcare costs.⁽³⁾

It may seem counterintuitive to think of preventive medicine when talking about chronic conditions, but these patients are actually at greater risk. Due to comorbidity and weakened immune systems, many patients with chronic conditions require greater vigilance. It is critical for these individuals to stay educated about their preventive needs, be up-to-date with their screenings and shots, and to keep their healthcare provider informed of any symptom changes.

Medicare Preventive Services: What Does it Cover

Medicare preventive medicine covers an Annual Wellness Visit (AWV) and much more.⁽⁴⁾ These benefits include, but are not limited to:

• Cardiovascular Disease Screening
• Bone Density Screening
• Pneumococcal Vaccine
• Diabetes Screening
• Cancer Screenings
• Depression Screening
• Glaucoma Screening
• Influenza Virus Vaccine

Despite the availability of these services, AARP estimates that less than one third of Americans age 50-64 are up-to-date with basic clinical preventive services.⁽⁵⁾ Their top recommendation is the use of provider and patient reminder systems. Through CareHarmony’s Care Pathways, our Care Coordinators remind patients which services they require and the necessity of these programs. By facilitating the use of Medicare Preventive Services, CareHarmony helps patients maintain their quality of life and access early intervention for serious diseases.

Case Study: Medicare Preventive Services and Influenza

Every year the CDC issues guidelines for influenza vaccines in its efforts to decrease the spread and severity of influenza.⁽⁶⁾ Despite the warnings and guidelines, a significant number of older Americans avoid getting the shot in the false belief that it will make them sick.⁽⁵⁾ In fact, the opposite is true. Influenza vaccines prevent complications among people with chronic conditions. Yes, a small percentage of people who receive the shot develop influenza, but the consequences are not as severe.⁽⁷⁾ In addition, some patients need different types of vaccines, depending on their condition.⁽⁶⁾ Through monitoring individual patient’s Care Pathway, CareHarmony’s Care Coordinators can help keep patients on track and decrease hospitalizations.

Reference

1. S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2014 Incidence and Mortality Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2017. Available at: www.cdc.gov/uscs.
2. Glasgow, R. E., Tracy Orleans, C., Wagner, E. H., Curry, S. J. and Solberg, L. I. (2001), Does the Chronic Care Model Serve Also as a Template for Improving Prevention?. Milbank Quarterly, 79: 579–612. [Online: June 28, 2017] http://onlinelibrary.wiley.com/doi/10.1111/1468-0009.00222/full
3. Centers for Medicare & Medicaid Services, “Medicare Preventive Services,” 2016, October. [Online: June 28, 2017] https://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/Downloads/MPS-QuickReferenceChart-1TextOnly.pdf
4. Centers for Disease Control and Prevention, “National Prevention Strategy: America’s Plan for Better Health and Wellness,” CDC Features, 2014, January 14. [Online: June 28, 2017] https://www.cdc.gov/features/preventionstrategy/
5. Multack, Megan, “Use of Clinical Preventive Services and Prevalence of Health Risk Factors among Adults Aged 50-64,” AARP Public Policy Institute, 2013, August. [Online: June 28, 2017] http://www.aarp.org/content/dam/aarp/research/public_policy_institute/health/2013/use-of-clinical-preventive-services-and-prevalence-of-health-risks-AARP-ppi-health.pdf
6. Centers for Disease Control, “What Vaccines are Recommended for You,” Vaccine Information for Adults, 2017, January 30. [Online: June 28, 2017] https://www.cdc.gov/vaccines/adults/rec-vac/index.html
7. Parry, Nicola M. “High-Dose Vaccine May Reduce Deaths During Severe Flu Season,” Medscape, 2017, March 3 [Online: June 28, 2017] http://www.medscape.com/viewarticle/876585