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ACA, Medicare Provided Preventative Care to 39M Patients in 2015

The ACA spread preventative care to millions of Medicare beneficiaries in order to improve population health and chronic disease management.

By Sara Heath

The Affordable Care Act (ACA) played a major role in increasing preventative care and chronic disease management amongst Medicare patients last year, according to an announcement from the Centers for Medicare & Medicaid Services.

Centers for Medicare & Medicaid Services CMS logo

In 2015, more patients took advantage of wellness visits and other preventative services as compared to 2014. In total, nine million patients took advantage of the wellness visits offered through Medicare, Medicare Advantage, and the ACA.

Over 5.8 million patients on only traditional Medicare took advantage of the wellness visit option, which is a near one million patient increase compared with 2014.

Even more patients utilized the other preventative services offered through Medicare and the ACA. In 2015 alone, 39.2 million patients utilized some sort of preventative care service, intervening in their own health before a condition grew worse and care expenses may have grown larger.

Although there was essentially no increase in the number of patients who accessed preventative care between 2014 and 2015, it is still promising to see the growth of preventative care since the implementation of the ACA.

On notable reason so many patients are accessing preventative care and wellness visits is due to an increase in patient engagement. According to CMS officials, patients are growing increasingly engaged, which is causing them to take charge of their care earlier, before they need emergency care intervention.

"Medicare consumers are now more engaged and empowered in their own health thanks to the Affordable Care Act," said Centers for Medicare & Medicaid Services (CMS) Acting Administrator Andy Slavitt. "Millions are now able to access more affordable prescription medicine for their chronic conditions and millions more are staying healthier by accessing preventive services, especially vital for people living with disabilities or growing older."

These numbers are indicative of a larger CMS effort to encourage patients to manage chronic diseases. In order to do that, the ACA eliminated barriers to care such as large deductibles or copays.

The Affordable Care Act added coverage of an annual wellness visit and eliminated coinsurance and the Part B deductible for certain recommended preventive services covered by Medicare, including many cancer screenings and other important benefits,” CMS said in a press release.

“By making certain preventive services available with no cost sharing, the Affordable Care Act removes barriers to prevention, helping Americans take charge of their own health and helping individuals and their providers better prevent illness, detect problems early when treatment works best, and monitor health conditions.”

Preventative care has proven an integral part in managing chronic disease, making it excellent news that a considerable number of patients are accessing it.

In a year-old study from the Johns Hopkins Bloomberg School of Public Health, researchers found that increased preventative care led to a 24 percent decrease in first-encounter strokes. Through regular screenings and visits with providers, patients were able to adjust their own personal care approaches in order to prevent more catastrophic events, such as a stroke in this case.

Research shows that these chronically ill populations are getting the preventative care they need, too. In addition to the recent numbers from CMS, studies have shown that chronically ill patients are receiving more preventative care, no matter the number or extent of the chronic diseases present.

As the healthcare industry continues to shift from fee-for-service reimbursement models to value-based payment models, preventative care is bound to arise. Between the growth of value-based payment models and the the emergence of new models like the Next Generation accountable care organization (ACO) programs, providers will increasingly be concerned with the patient’s overall wellness rather than treating at each individual instance of care.


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