Medicare reimburses for cancer and other screenings as part of routine care for older adults. Of course, the goal is to catch diseases in their earliest, most treatable stages. But can preventive care become too much of a good thing?
For years, evidence has grown about wasted Medicare dollars on needless screenings. The Center for Public Integrity found that 40 percent of Medicare spending on common cancer screenings are unnecessary – costing billions of taxpayer dollars. Continue reading
Photo: Alex Prolmos via Flickr
High-deductible health plans (HDHPs) discourage families from seeking primary care for their children, according to the American Association of Pediatricians. The problem is so severe that the federal government should consider limiting HDHPs to adults only, the AAP said in a policy statement published in Pediatrics.
“HDHPs discourage use of nonpreventive primary care and thus are at odds with most recommendations for improving the organization of health care, which focus on strengthening primary care,” the association said in its statement. Under the Affordable Care Act, preventive services are covered in full without charge.
This is the second time in as many months that a report has shown consumers skipping needed care because of the cost. Last month, we reported that out-of-pocket health care costs force one out of every eight privately insured Americans to skip necessary medical treatment, according to the survey from the AP-NORC Center, “Privately Insured in America: Opinions on Health Care Costs and Coverage.” The Robert Wood Johnson Foundation funded the survey. In a report earlier this month, “Too High a Price: Out-of-Pocket Health Care Costs in the United States,” the Commonwealth Fund expressed similar concerns. Continue reading
Photo by Pia ChristensenJonathan Bowser of the University of Colorado School of Medicine called oral health “the low-hanging fruit of primary care prevention.”
In 2007, a 12-year-old Maryland boy named Deamonte Driver died from a tooth infection that spread to his brain. His family had lost Medicaid coverage and an $80 tooth extraction might have saved his life, wrote Washington Post staff writer Mary Otto, whose story helped spotlight oral health disparities.
Oral disease is a disease of poverty, said Diane Brunson, R.D.H., M.P.H., director of public health and interprofessional education at the University of Colorado School of Dental Medicine, during a session called “Covering disparities in oral health,” at Health Journalism 2014 in Denver. Continue reading
“The idea of the wellness trust is to create a pool of money that can effectively address the social determinants that are making our families sick and the vast disparities in health and access based on which ZIP code you live in,” Jim Mangia, CEO of a network of 10 community clinics in south Los Angeles, told journalist Rob Waters.
I’d never heard of a “wellness trust” until I stumbled upon Mangia’s engaging Q&A with Waters, who blogs about health and science over at Forbes. Mangia is part of a coalition of labor and community groups trying to establish a wellness trust with funding obtained via a state law that mandates that a certain percentage of profit made by hospitals be spent on community benefits. Here’s Mangia:
“If you look at where the money is in healthcare, it’s with hospitals, health plans and insurance companies. So if you’re going to reorder the priorities of a healthcare system in a particular area, you have to use the resources of the system’s wealthiest elements. The issue is: Are these community benefit dollars actually being used for community benefits? I think some are and some aren’t. We’ve done research and know that cities and counties have some power to decide how those community benefits are spent. It’s through that process we think we can create this trust.”
Image by sunnyviewdental via flickr.
Adult dental benefits would be added to South Carolina’s Medicaid program under a plan being considered by the state legislature.
Preventive and restorative dental benefits for poor adults are part of a package of proposed Medicaid enhancements that also includes health screenings and weight-loss help, Seanna Adcox reported in a Feb. 5 story for The Associated Press.
The new benefits were part of state Medicaid Director Tony Keck’s budget presentation before a House Ways and Means panel, Adcox wrote. The initiatives would cost $15.3 million from state taxes and $52 million total when including federal money.
Currently, the state Medicaid program covers only emergency tooth extractions in specific cases of medical necessity. Continue reading
Here’s a trend to watch: More employers are using both financial incentives (the carrot) and penalties (the stick) in wellness programs. A number of publications have covered the issue of employers using penalties, perhaps because the penalties are a relatively new development.
For many years, employers have used incentive payments and other inducements to encourage workers to participate in wellness programs. But a rising number of employers are using financial penalties to encourage participation.
In July, Pennsylvania State University told its employees and their spouses that they would face a $100 monthly surcharge unless they completed a biometric screening and an online wellness profile and certified that they have had or will have a physical exam. Penn State added that it would not have access to the health screening results.
Dena Bunis, managing editor at CQ HealthBeat, covered this story and reports (via the Commonwealth Fund) that as part of the biometric testing, employees and spouses have to get blood pressure and fasting blood tests and height and weight measurements. In emails, faculty and staff have raised questions about why the university decided to encourage participation with a penalty rather than a financial incentive, Bunis wrote. Continue reading