The Urban Institute recently released a report documenting the potential savings available in prevention of avoidable chronic illness. The high and rising prevalence of chronic disease represents a substantial burden on the medical care system and a major cost for society, leaving aside its toll on individuals. The burden presents as rising rates of obesity, increased prevalence of diabetes, greater incidence of disability, and the rising cost of medical care and other disease-related costs. The Congressional Budget Office (CBO) reports that medical spending on obese adults is 38 percent higher than on their normal-weight counterparts. The cost of cardiovascular disease in medical treatment and lost productivity has been estimated at $400 billion per year, of which about one-quarter comes from lost productivity. The California Public Employees' Retirement System (CalPERS) health program covers...

The Commonwealth Fund recently published a paper in Medscape Public Health regarding preventive health services under the Affordable Care Act (ACA). The law has already extended coverage to dependents through age 26. By 2014, Medicaid will expand to cover most low-income adults and the exchanges will extend insurance to many small business and individuals. This eminent expansion of health insurance coverage will greatly increase in the use of preventive services in the United States. ACA provisions also eliminate cost sharing associated with the provision of preventive services, which will also likely impact use. Finally, the movement toward medical homes will also augment the use of preventive services. The paper discusses these relationships in the context of delivery system reforms.

According to a report released by the Government Accountability Office, Medicare coverage of preventive services is not consistently aligned with recommendations by the U.S. Preventive Services Task Force. Preventive care services have the potential to improve health outcomes and lower health care expenditures. Thr report examines (1) whether preventive service use by Medicare fee-for-service (FFS) beneficiaries aligns with recommendations from the U.S. Preventive Services Task Force and the Advisory Committee on Immunization Practices (ACIP), (2) use of the Welcome to Medicare (WTM) exam and its association with use of preventive services, (3) preventive service use in Medicare Advantage (MA) relative to FFS, and (4) service use among MA health maintenance organizations (HMO) and efforts by high-performing HMOs to encourage preventive care. To do this, GAO selected eight preventive services that had Task Force or ACIP guidelines for the general Medicare population. GAO analyzed the most recently available data from Medicare claims, a beneficiary survey, and MA plan ratings. GAO also interviewed representatives of selected HMOs. GAO recommends that Congress consider...