Once an underused component of the health care world that benefits both employees’ health and employers’ health care spending, preventive care is now a mandatory part of any health benefits package. Preventive care consists of measures taken to prevent diseases, rather than curing them or treating their symptoms.
There is significant research demonstrating that increased use of effective preventive services will result in less suffering from ailments that could have been prevented had they been detected and treated early on. Preventive care is often more cost-effective than treating diseases once symptoms appear. Some preventive care services even save more money than it costs to implement them.
Under the Affordable Care Act (ACA), private insurers—except for plans that have been grandfathered—are required to cover certain preventive services without any cost to the patient. Medical services such as immunizations, screening tests, medications and any other services that would prevent disease, injury and premature death fall under the umbrella of preventive care.
Preventive care should be incorporated into employer-sponsored health plans to lessen the cost and number of future medical claims by helping employees and their families stay healthy, while also complying with the provisions of the ACA.
Preventive Care for Adults
The following types of preventive care are available to all adults within specified age ranges or risk groups.
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- Abdominal aortic aneurysm screening: A one‐time screening for abdominal aortic aneurysm by ultrasonography in men ages 65 to 75 who have ever smoked.
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- Colorectal cancer screening: Screenings for colorectal cancer using fecal occult blood testing, sigmoidoscopy or colonoscopy, beginning at age 45 and continuing until age 75. The risks and benefits of these screening methods vary. About 19,000 diagnoses could be prevented annually if people get screened, yet only one-third of adults complete regular screenings.
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- Depression screenings: Screenings for depression when staff-assisted depression care supports are in place to ensure accurate diagnosis and effective treatment and follow-up.
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- Diabetes screening: Screenings for adults 40 to 70 years who are overweight or obese.
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- Diet counseling: Intensive behavioral dietary counseling for adult patients with hyperlipidemia and other known risk factors for cardiovascular and diet‐related chronic disease. Intensive counseling can be delivered by primary care clinicians or by referral to other specialists, such as nutritionists or dietitians.
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- HIV screenings: Screenings for everyone ages 15 to 65 and other ages at increased risk.
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- Obesity screening and counseling: Screening for all adults; clinicians should offer or refer patients with a body mass index (BMI) of 30 or higher to intensive, multi-component behavioral interventions.
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- Sexually transmitted infection (STI) prevention counseling: Counseling for adults at higher risk.
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- Syphilis screening: Screenings for adults at greater risk.
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- Tobacco use screening: Screenings for adults at higher risk; tobacco users may receive intervention and cessation support. A comprehensive, effective smoking cessation program usually costs less than 50 cents per member per month, or less than $6 per member per year. You can save an average of $210 on yearly health care costs for each smoker who quits.
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- Vaccinations: Shots for hepatitis A, hepatitis B, herpes zoster, human papillomavirus (HPV), influenza, measles, mumps, rubella, meningitis, pneumococcal disease, tetanus, diphtheria, pertussis and varicella; doses, recommended ages and populations vary.
In addition to mandated no-cost preventive care, there are other existing preventive services that may be included by an insurer as part of a health group plan. These include things like adult vision and hearing screenings and vitamin and mineral supplements. Check with your insurer to see if additional preventive services are available for your plan’s recipients.
Maximizing Your Health Plan
How can you take advantage of the cost-saving potential of some of these preventive care services? Here are some ways that you can maximize your health care investment :
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- Educate your employees on the preventive care services that your health plan offers, their potential risk factors and the benefits of preventive medicine.
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- Find ways to make preventive care more convenient for your employees by working with nearby clinics, developing an on-site clinic or hosting a mobile van for vaccinations and screenings
- Educate your employees on preventable health conditions. Your Consociate Health representative can provide you with payroll stuffers, flyers and posters to help educate your employees.
