Beginning January 2011, a key PPACA provision will take effect, helping to improve and better coordinate care for seniors. This is a key demographic for prevention, disease management and care coordination efforts, as more than half of Medicare beneficiaries are treated for five or more chronic conditions yearly, with six chronic ailments accounting for 40 percent of the recent rise in Medicare spending.

Starting in January, Medicare beneficiaries will receive, for free, all preventive services and screenings that receive an A or B recommendation for seniors from the U.S. Preventive Services Task Force, including mammograms and colorectal cancer screening, bone mass measurement and nutritional counseling for people at risk for lifestyle-related chronic diseases such as diabetes. While what tests and treatments a patient should receive is a decision to be made between the patient and his or her doctor and team of health care professionals, many preventive services are recommended for a wide audience. 

Medicare beneficiaries will also get a free annual wellness visit under PPACA. The annual wellness exam allows seniors to make a custom health plan with their primary care physician and also provides them with a key opportunity to learn about healthy behaviors and services, such as healthy eating and community exercise programs, not covered by Medicare. Educating seniors about healthy living is critical in preventing obesity, a chronic condition that often leads to other chronic disease, such as diabetes and hypertension, and further increases health spending. Research has shown that lifetime spending for older adults is $25,000- $37,000 lower among normal weight adults, compared to obese adults.

Eliminating cost sharing for seniors means more will get the preventive care they need, keeping them healthy and ultimately reducing federal health spending. The wellness visit and nutritional counseling (primary prevention) will help prevent future costs by preventing illness, while the screenings (secondary prevention) will help reduce  cost by early management of the disease. Today’s Washington Post article, “New health-care law provides free preventive care for many seniors,” discusses the benefits of the new provision at length. As announced last week by the White House, Medicare reforms in PPACA are already generating cost savings within the program, and these added preventive and care coordination efforts will generate further cost savings over time.