Preventive Care: Finally Covered, Says Don Berwick

Donald M. Berwick, MD, MPP


June 21, 2011

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Hi, I'm Dr. Don Berwick, Administrator of the Centers for Medicare & Medicaid Services.

As physicians, we are on the front lines of improving health care. We know the value of having patients get the right preventive care -- it means healthier lives and catching problems early.

Prevention isn't just good for patients. As we're looking at how we make our health care system more sustainable in the long run, investing in prevention makes financial sense, too. That's especially true for secondary prevention -- preventing deterioration in chronic illness. As much as three quarters of the $2.5 trillion-plus that we spend on US health care each year goes to paying the bills for chronic illness, and we know a ton about how to keep chronically ill patients out of the hospital and functioning at the highest level they can.

Each dollar that we spend today on cancer screenings and counseling on healthy lifestyles means fewer dollars that we'll be spending on cancer treatments, coronary bypass surgeries, and treatment for chronic conditions years down the line.

You're working day in and day out to help patients live healthy lifestyles. Now it's up to us in Washington to make sure that the way that we pay for health care reflects these values as well.

Fortunately, the Affordable Care Act has given us new tools to give patients easier access to preventive care. Starting in January, Medicare eliminated its Part B deductible and copayments for a host of proven preventive services, including bone mass measurement, some cancer screenings, diabetes and cholesterol tests, and flu, pneumonia, and hepatitis B vaccinations, among other services.

Medicare now covers annual wellness visits. It covers smoking-cessation counseling. It began paying a 50% rebate for the brand-name medications that seniors need to manage chronic conditions when they reach the coverage gap known as the "doughnut hole."

Your patients in new private insurance plans also won't pay out of pocket for many preventive services, including screening blood pressure, diabetes, and cholesterol, and for certain cancer screenings; counseling to quit smoking or cut alcohol consumption; routine vaccinations; and regular well-baby and well-child visits, from birth to age 21.

We're working to make sure that you and your patients have the support you need to achieve better health. Our investment in prevention takes a big step in that direction. If you or your patients are looking for more detailed information, go to and click on "Learn About Prevention" at the top.


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