HHS Promotes New Medicare Preventive Benefits for Better Senior Health
HHS Secretary Tommy G. Thompson today announced the availability of new Medicare preventive benefits designed to provide seniors with better care and a higher quality of life. He also praised the American Cancer Society, American Diabetes Association and the American Heart Association for joining with HHS on an education and outreach effort.
"For too long Medicare only paid for benefits after you got sick. Now, Medicare will pay for benefits that will help seniors prevent the onset of disease before it becomes serious," Secretary Thompson said. "These new changes bring Medicare into the 21st century of medicine. Starting this year, seniors will have better and greater access to benefits to help keep them healthy and improve their quality of life."
As of Jan. 1, 2005, people with Medicare can take advantage of three important new Medicare benefits: a one-time "Welcome to Medicare" physical exam, cardiovascular screening, and diabetes screening.
Secretary Thompson also announced a new collaboration on education and outreach with the Centers for Medicare & Medicaid Services (CMS) led by CMS Administrator Mark B. McClellan, M.D., Ph.D., and the leaders of the American Cancer Society, the American Diabetes Association and the American Heart Association. The campaign is designed to help maximize attention to Medicare's new preventive benefits and to help seniors use them.
"What we want seniors to know is that they can live healthier lives through these new benefits," Dr. McClellan said. "Together, with well-respected preventive health leaders, we have formed a strong partnership to make sure every Medicare beneficiary takes advantage of these new benefits that will lead a better quality of life."
New Medicare beneficiaries now have the "Welcome to Medicare" physical exam, coupled with an increasingly broad set of preventive benefits that will include prescription drug coverage next year. These provide people with Medicare greater access to more prevention-focused benefits than ever before. The services are key features of the Medicare Modernization Act (MMA), signed into law by President George W. Bush in December 2003.
"Medicare's new emphasis on prevention and early detection marks a dramatic shift that will help us in the fight against cancer," said American Cancer Society's Chief Executive Officer, John R. Seffrin, Ph.D. "The new physical exam benefit will be a gateway for doctors to not only recommend patients for screening tests, but also to counsel them about risk factors for cancer-- tobacco use, diet and physical activity."
The physical exam is aimed at providing education and counseling about the preventive services that may be needed. Dr. McClellan said he believes the exam will significantly improve the health prospects of Medicare beneficiaries as they enter the program by helping them take advantage of preventive measures they may not have known were needed.
In addition to the physical and other benefits added in recent years, Medicare's comprehensive set of preventive benefits includes screening services for the following:
Medicare also recently announced its intention to cover smoking cessation counseling for beneficiaries who have smoking-related diseases.
"Approximately half of all diabetes cases occur in people older than age 55. For seniors with diabetes, early access to quality treatment, health care team education, and patient education are all very critical. The new preventive benefits for people with Medicare will assist seniors greatly in meeting these needs," said American Diabetes Association's Chief Executive Officer, Lynn B. Nicholas, FACHE.
The event today is part of an ongoing HHS emphasis on preventive health care. Last fall, Secretary Thompson launched a coordination of resources between HHS agencies, specifically CMS and the Centers for Disease Control and Prevention, to maximize preventive health care. HHS is also working closely with members of Congress as part of the broad outreach campaign to make sure Medicare beneficiaries are aware of the preventive benefits.
"We applaud Secretary Thompson for bringing a renewed emphasis on prevention to the nation's public health priorities," said American Heart Association's Chief Executive Officer, M. Cass Wheeler. "The new benefits go a long way to empowering Medicare beneficiaries to help keep themselves heart healthy and stroke free."
Increasing the use of preventive services, Dr. McClellan noted, could save many thousands of lives and billions of dollars in avoidable medical expenses for preventable complications associated with heart disease, diabetes, cancer, weak bones, high blood pressure, smoking, inactive lifestyles, and other illnesses and unhealthy behaviors.
"Historically, the vast majority of Medicare's spending has gone to treating costly health problems after they occur," said Dr. McClellan. "We are changing that now as we help seniors use preventive care, and that along with next year's prescription drug coverage will help them avoid many costly and debilitating problems. Now that we've closed the gap in benefits, we're working to close the 'prevention gap' -- the difference between our expert recommendations on preventive care and the actual use of preventive care by seniors."
For example, Dr. McClellan noted, 56 percent of Americans 50 and older do not get screening tests that can detect colon cancer at an early, treatable stage, despite the fact that Medicare covers such tests. When colon cancer is caught early, survival rates are over 90 percent.
Dr. McClellan also noted that Medicare Advantage plans have already been providing many of the new benefits, and these "coordinated care" plans have the flexibility to cover many additional preventive services, such as wellness programs, beyond what traditional Medicare covers. Medicare Advantage plans often offer prevention benefits including wellness programs, health education services, exercise programs and other services that not only alert patients to potential health risks, but also actually work with them to change harmful lifestyles and encourage healthy behavioral changes. With the new Medicare law, expanded preventive benefits through Medicare Advantage plans are more widely available to Medicare beneficiaries.
Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.
Last revised: January 10, 2005