Wednesday, August 4, 2010

Patient Access Should Prepare for the Rise of Preventative Care

A major provision of healthcare reform is the expansion of preventive care. Americans will be encouraged by their health plan to receive care to prevent illness. Currently, many patients have felt pressured to forgo needed, preventive care, due to high co-pays, deductibles, and coinsurance. Finally, these financial barriers to care are being eliminated through The Patient Protection and Affordable Care Act.

Effective September 23, 2010, new plans from private insurers will be required to eliminate co-pays, deductibles, and coinsurance for preventive services. Medicare and Medicaid will follow suit on January 1, 2011. This provision will have a positive impact on the heath of our communities.

Patient Access leaders can prepare for this provision in a number of ways:

1. Analyze current volumes of preventive services/screening exams and develop methods to track new volumes, beginning January 1, 2011. Some examples are screening exams for: cardiac conditions, diabetes, cancer, prostate illness, prenatal care, and wellness for women and infants.

2. Educate staff that collections are not necessary for preventive care/screening exams and exclude these services from identified opportunity.

3. Increase competency, through training and education, on interpreting on-line eligibility data, benefits and identifying preventive care exams.

AAFP American Academy of Family Physicians
Agency For Healthcare Research and Quality

Michael Sciarabba MPH, CHAM is a member of the NAHAM Government Relations Committee.

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