Health Care Costs and Financing

Employers are least likely to offer insurance coverage for preventive care services that provide the financial return they seek

Clinical preventive services such as immunizations, cancer screening, and tobacco cessation can improve a person's health. Health insurance coverage helps people access these services, but a new study indicates that employers are least likely to offer coverage for the preventive services that are most likely to provide the financial return they seek.

David Atkins, M.D., M.P.H., of the Center for Outcomes and Evidence, Agency for Healthcare Research and Quality, and colleagues analyzed data from the 2001 National Survey of Employer-Sponsored Health Plans. The survey asked about coverage of clinical preventive services in these plans and at the worksite, as well as employers' approaches to covering these services and factors affecting their decisions. The researchers examined responses by 2,180 employers to 8 survey questions on health promotion.

More than 90 percent of employers included increased productivity and decreased health care costs among their most important reasons for coverage of clinical preventive services. Plan coverage of physical examinations, immunizations, and screenings generally exceeded 50 percent, but coverage of lifestyle modification services was less than 20 percent. For example, only 20 percent of employers offered counseling to help people quit smoking and 18 percent offered alcohol problem prevention. Also, only 55 percent of employers covered adult influenza vaccination. Yet, all of these preventive services have been found to have a positive impact on health.

Coverage for preventive procedural services, such as immunizations and screenings for cancer and other diseases, was better. Coverage rates for colorectal cancer screening and adult immunizations were low, however, compared with their relatively high value in preventing costly health problems. Employers could substantially increase the impact and value of their health-related benefits by small additions to coverage of clinical preventive services, conclude the researchers.

See "Employer coverage of clinical preventive service in the United States," by Maris Ann Bondi, M.P.H., M.H.S., Jeffrey R. Harris, M.D., M.P.H., M.B.A., Dr. Atkins, and others, in the January 2006 American Journal of Health Promotion 20(3), pp. 214-222. Reprints (AHRQ Publication No. 06-R032) are available from The AHRQ Publication Clearinghouse.

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