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CMS is committed to promoting the appropriate use of Medicare preventive benefits. Medicare covers a broad range of services to prevent disease, detect disease early when it is most treatable and curable, and manage disease so that complications can be avoided. Unfortunately, older adults are not receiving all recommended preventive services, even with frequent visits to physician offices. Reasons for this vary, but highlight the opportunity to improve preventive care for older adults. The CMS Prevention section is an information resource to help support the delivery and promotion of Medicare preventive benefits, including: - "Welcome to Medicare" visit (includes a referral for an ultrasound screening for Abdominal Aortic Aneurysm for eligible beneficiaries)
- Adult Immunization--Influenza Immunization, Pneumococcal Vaccination, Hepatitis B Vaccination
- Colorectal Cancer Screening
- Screening Mammography
- Screening Pap Test and Pelvic Examination
- Prostate Cancer Screening
- Cardiovascular Disease Screening
- Diabetes Screening
- Glaucoma Screening
- Bone Mass Measurement
- Diabetes Self-Management, Supplies, and Services
- Medical Nutrition Therapy
- Smoking Cessation
Each preventive benefit section contains separate pages providing information, resources, and tools for providers delivering services to beneficiaries, organizations communicating prevention information with beneficiaries, and researchers interested in prevention-related studies. The information, resources, and tools on these pages include materials CMS and other organizations have created to help support the delivery and awareness of preventive services, such as billing and coding information, checklists, and communication materials. The Prevention-General Information section contains several pages related to prevention and wellness. Two pages provide information on the use of Medicare's preventive benefits. The "Medicare Claims Data" page contains research that has been done on the use of Medicare preventive services based on Medicare claims data. It includes an interactive database featuring preventive services' use and expenditures data, which can be examined at the national, state, and county level, as well as by specific demographic groups at the national and state level. Special analyses of specific preventive services, such as biennial mammography rates, and information on the percentage of Medicare beneficiaries that have ever had a claim for the pneumococcal vaccination, are also featured in this section. The "Self-Reported Data" page contains information from questionnaires and surveys that have asked Medicare beneficiaries about their use of preventive services. Analyses of responses to the Medicare Current Beneficiary Survey, and the Consumer Assessment of Health Plan Satisfaction or CAHPS, are available as downloads on this page. Supplemental analyses on specific subgroups of the Medicare population are also available on this page. The page also contains a link to the National Center for Health Statistics Trends in Health and Aging Warehouse, which provides information on the use of preventive services and health behaviors gathered from various surveys administered by the Centers for Disease Control and Prevention, as well as other information on the health of older adults. It is important to note that Medicare claims and self-reported data have limitations. For example, Medicare claims data are not the best source of information regarding the use of flu shots because providers do not always bill Medicare for this service. In addition, data on the use of Medicare preventive services varies, depending on the data source used. For example, utilization rates based on beneficiary self-reported data tends to be higher than Medicare claims data. We recommend reading the Data User's Guide in the Downloads section below to understand the advantages and disadvantages of these different data sources in examining utilization rates for preventive services. The "Healthy Aging" page includes reports that CMS and others have produced on various health promotion, disease prevention, and wellness topics related to older adults. This page provides links to various prevention and wellness resources, including: - A variety of educational products for health care professionals to help increase awareness of preventive services covered by Medicare and provide coverage and billing information needed to effectively bill Medicare for preventive services provided to Medicare patients.
- The web site for the Medicare Learning Network (MLN), the brand name for official CMS educational products and information for Medicare fee-for-service providers.
- The U.S. Preventive Services Task Force, the leading independent panel of private sector experts in prevention and primary care. Its recommendations are considered the "gold standard" for clinical preventive services.
- Healthy Aging information from other agencies in the Department of Health and Human Services.
Page Last Modified: 08/05/2008 7:57:11 AM
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