Affordable Care Act Prevention Benefits Increasing Access, Lowering Costs for People with Medicare

Partnership for Prevention is pleased to learn that in only two months over 150,000 Medicare beneficiaries have received the annual wellness visit authorized in the Affordable Care Act (ACA). This good news comes on the heels of an HHS report earlier this week indicating that those over 65 are not getting the preventive services they need.  Click here for HHS news release.

The ACA requires a health risk assessment (HRA) for Medicare beneficiaries to assist in developing personalized prevention plans. Partnership has been working with the Centers for Disease Control and Prevention (CDC) and the Centers for Medicaid and Medicare Services (CMS) to develop guidance for implementing this important tool. Specifically, Partnership organized and helped lead a Public Forum meeting in response to a Federal Register Notice for public comments and submitted, with Thomson Reuters, a report that CDC will use to inform CMS on the development of guidance for the HRA.

For additional information about Partnership’s work on the annual wellness visit and HRA, please click here or contact Jason M.M. Spangler, MD, MPH, FACPM, Chief Medical Officer, Partnership for Prevention, jspangler@prevent.org.

Older Adults Lack Preventive Care

Adults over the age of 65 are not getting the preventive services that they need, according to a report released by the Department of Health and Human Services on Monday. The report found that preventive services, including vaccinations, tobacco cessation, and screening for cancer, diabetes, lipid disorders, and osteoporosis are underutilized. The report emphasizes that adults over 65 should be taking advantage of preventive services on a regular basis, and notes that many beneficiaries don’t know what services are covered by Medicare.

As a provision of the Affordable Care Act, certain USPSTF A and B recommended preventive services are covered without cost sharing by Medicare patients. In order to promote uptake of preventive services, including those services that are currently underutilized, Medicare has instituted an annual wellness visit. The wellness visit will allow Medicare beneficiaries access to preventive services on a regular and continued basis. It will be based on a detailed Health Risk Assessment (HRA), which allows patients and providers to create a personalized prevention plan. Partnership for Prevention, along with the CDC, has assisted the Centers for Medicare and Medicaid Services (CMS) in the effort to design and implement the HRA by interviewing and convening a group of HRA experts.

Medicare coverage, along with outreach and education for the annual wellness visit, will help to bring awareness to the need for and use of preventive services for those over the age of 65.


Rebecca Doigan, MPH
Research Fellow and Program Associate