MIR-2006-8AB, August 2006

Together We Can Close the Prevention Gap!

This message was previously sent on July 7, 2006, under 200607-05. It is being republished to clarify that Medical Nutrition Therapy is available as a Medicare-covered preventive service for Medicare beneficiaries with diabetes OR renal disease (subject to certain eligibility and other limitations).

Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States. Although chronic diseases are among the most common and costly health problems, they are also some of the most preventable. Over the years, Medicare has continued to expand the range of preventive services for which it pays and now provides coverage for the following preventive services and screenings (subject to certain eligibility and other limitations):

While the number of Medicare-covered preventive services is higher than ever, we are finding that many beneficiaries are not taking advantage of the full range of services for which they may be eligible. Some of the reasons for this under-utilization include beneficiaries:

• Not knowing that these services are covered by Medicare;
• Being afraid to talk with their physician or not knowing how or what questions to ask;
• Not understanding the value of prevention, early detection and treatment;
• Fearing the pain that may occur during the preventive service procedure; or
• Fearing the results of the preventive service procedure.

In addition, there may be physical and social barriers that prevent Medicare beneficiaries from obtaining preventive services.

How Can You Help?
Regardless of the reason for your Medicare patient not using a service, you are in a key role to help address this problem. The Centers for Medicare & Medicaid Services (CMS) needs your help to ensure that people with Medicare are aware that Medicare provides coverage for preventive services that could save their lives. You can help by doing the following:

• Talk with your patients about their risk for disease and the value of prevention and early detection, and encourage utilization of appropriate Medicare-covered preventive services.
• Perform or provide referrals for the appropriate preventive services.
• Follow-up with patients on all screening results, even negative ones.
• Provide information about appropriate lifestyle modifications that support a healthy lifestyle.

For More Information
CMS has developed a variety of educational products and resources to help health care professionals and their staff to become familiar with coverage, coding, billing, and reimbursement for preventive services covered by Medicare.

• The MLN Preventive Services Educational Products Web Page ~ provides descriptions and ordering information for all provider specific educational products related to preventive services. The Web page is located at www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp#TopOfPage on the CMS Web site.
• The CMS Web site provides information for each preventive service covered by Medicare. Click on www.cms.hhs.gov, select “Medicare,” and scroll down to “Prevention.”

For products to share with your Medicare patients, visit www.medicare.gov on the Web.

As a trusted source of patient health care information, your recommendation is one of the most important factors in increasing the utilization of preventive services covered by Medicare. We hope that you will join with CMS as we strive to close the prevention gap and encourage appropriate utilization of preventive services. It could save seniors’ lives. Thank you so much for your help!

CMS Learn Resource 200607-11