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Wednesday Jul 01, 2015

What Patients Don't Know Can Hurt Them

It has been more than five years since the Patient Protection and Affordable Care Act (ACA) became law, but many consumers still remain unaware of one of the law's signature provisions: coverage of preventive services without cost-sharing.

A baby receives the rotavirus vaccine. Many Americans remain unaware that most health plans are now required to cover preventive services, including vaccinations, without cost-sharing.

The White House and HHS recently launched a joint Healthy Self campaign(www.hhs.gov), which is designed to connect Americans to the health care they need and encourage them to take a more active role in their health. Fifty events will be held across the country in August to connect patients with care. The effort includes educating people -- particularly the newly insured -- about preventive services they are guaranteed under the ACA, which survived another Supreme Court challenge last week.

A Kaiser Family Foundation poll(kff.org) conducted shortly before last year's open enrollment deadline, showed that less than half of uninsured Americans were aware that the recommended preventive services(aspe.hhs.gov) most health plans are now required to cover must be provided with no cost-sharing. Those services include:

  • blood pressure screening;
  • breastfeeding support and supplies;
  • contraception;
  • depression screening;
  • domestic violence screening and counseling;
  • HIV screening;
  • immunizations;
  • obesity screening and counseling;
  • tobacco cessation interventions;
  • well-child visits; and 
  • well-woman visits.

Considering that lack of awareness about these benefits, it's no surprise that half of the uninsured who were polled said they planned to stay uninsured.

However, more than 16 million people have gained health coverage under the ACA, according to the Healthy Self campaign announcement. That's significant because prevention is the key to true health care. Chronic diseases are responsible for 70 percent of U.S. deaths and 75 percent of our health care costs. Imagine the difference we can make simply by helping patients understand the services they have access to in our practices. If people delay preventive care because of cost concerns, they're more likely to eventually end up spending even more money at urgent care centers and ERs.

So what can we do as family physicians? We can use electronic health records to review what services patients haven't had. Our practices can use phones, email, portals and even social media to encourage patients to come in for preventive care. We also can use acute visits to identify preventive service gaps and schedule follow-up.

It's worth noting that CMS has launched a Web page with resources(marketplace.cms.gov) to help the newly insured understand their benefits and to connect them with primary care physicians who can provide preventive services.

Reid Blackwelder, M.D., is Board chair of the AAFP.

Posted at 02:56PM Jul 01, 2015 by Reid Blackwelder, M.D.

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