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Improved Access to Preventive Care for Seniors

A newly proposed regulation will expand Medicare services, including providing for an annual wellness visit and eliminating out-of-pocket costs for most preventive services.

The Affordable Care Act created a number of important new benefits for seniors and other Medicare beneficiaries.  On Friday, the Centers for Medicare & Medicaid Services (CMS) issued a proposed regulation that takes us a step closer to making those promised benefits a reality.

Under the provisions of this proposed rule, Medicare would provide for expanded access to preventive services and promote the early detection and prompt treatment of medical conditions for the seniors and people with disabilities in the program.

Starting next year, Medicare beneficiaries will be eligible for a new benefit: an annual wellness visit with their primary care physician.  This annual wellness visit will give patients and doctors the opportunity to develop personalized prevention plans that will help patients maintain or improve their health and reduce risks of chronic disease.  A comprehensive prevention plan that is tailored to an individual’s medical needs is key to ensuring coordinated care, identifying gaps in care, and maintaining appropriate access to needed medical services.

Also starting next year, Medicare beneficiaries will no longer have to pay any out-of-pocket costs for most preventive services.  Services that will be free include the annual wellness visit and many life-saving cancer screenings that seniors may not have received in the past because of cost barriers.  Colon cancer screening, for example, may cost a senior $100 or more today.

In addition to providing these new benefits, the rule would provide bonus payments to encourage health care providers to serve Medicare beneficiaries in underserved areas and to provide preventive services.  Payments for primary care services would be boosted for doctors, nurse practitioners and other health care providers.  Surgeons serving underserved communities would also receive a pay increase.

The implementation of these new benefits, and others created by the Affordable Care Act, is just part of the work the Obama Administration is doing to promote wellness and reduce chronic disease.  We are investing in growing the primary care workforce, and expanding access to preventive services and the public health infrastructure.  Under the Affordable Care Act, HHS will be drafting a national strategy to improve the nation’s health, expand every insured American’s access to preventive care and support employer wellness programs.

To learn more about how the proposed rule would expand benefits for Medicare beneficiaries, check out the fact sheet.

Kathleen Sebelius is Secretary of Health and Human Services