There are two main obstacles to seniors taking advantage of preventative services and the solution lies with physicians.
Virtually all of Medicare’s expenditures - 99 percent - are for beneficiaries with at least one chronic condition. With this in mind, it makes sense that preventing or slowing the progression of chronic illness is an important step to reducing the cost of healthcare in our country, which totaled $2.7 trillion in 2011.
Medicare’s Annual Wellness Visit (AWV) is an ideal strategy to prevent the development or exacerbation of chronic illness. However, recent statistics show that less than 10 percent of Medicare beneficiaries have taken advantage of their free wellness visit. In addition, only 33 percent of women and 40 percent of men aged 65 years and older were up to date on recommended preventive services.
Why aren’t seniors taking advantage of preventive services, including the AWV? The answer to this question is two-fold, and the solution lies with physicians:
1. Lack of awareness. While Internet use for all people over age 18 is 83 percent, usage drops to 53 percent for people 65 and older, and drops even more - to 34 percent - for people 75 and older, according to a recent study by the Pew Internet and American Life Project. This means seniors are relying on printed communication, traditional broadcast media, and personal communication to learn about services that can improve the quality of their lives and cut healthcare costs.
A key personal interaction that occurs regularly for most seniors is a physician visit, yet we generally see patients only to treat acute illnesses and chronic conditions and update prescriptions. Taking a few extra minutes to tell patients about the availability of a free wellness visit that can provide a holistic view of their health - as well as a roadmap to services that can keep them healthy - is a critical responsibility of all physicians.
2. Concern about cost. Although there is no cost to the patient for the AWV and approximately a dozen other preventive services, savvy Medicare patients know that any diagnostic tests besides the CMS-approved services such as an echocardiogram to identify early chronic disease may require a $50 copay for a test such as an echocardiogram represents a significant expense for many patients, given the rising cost of living in today’s economy coupled with the static or shrinking income of a senior’s household. So, it’s up to us to clearly explain the benefits - both clinical and financial - of paying $50 now to potentially avoid the hundreds of dollars required for a cardiac-related hospital stay.
Studies have shown that for every $1 invested in preventive services there is a $3.27 savings in the overall cost of healthcare. Not only is this significant for Medicare and other payers, it’s also important for our patients - financially and medically. Patients who take steps to improve health and reduce the risk of chronic conditions enjoy a better quality of life than those with chronic illnesses. Because they are healthier, more energetic and more physically active, they tend to require fewer medications, which also reduces the risk of other complications, such as falls.
As physicians, it’s important that we assume some responsibility for educating seniors about the AWV, as well as age-appropriate preventive measures. Then, we must offer these much needed services in our practices.
Averel B. Snyder, MD, is co-founder and chief medical officer of Senior Wellness Solutions, which provides innovative technology-based solutions to identify symptoms of early chronic disease and streamline patient care. A board-certified cardiothoracic surgeon, Snyder also has an AMA certification in age management, an ISSA Certification in fitness and nutrition, and a USFA certification in senior citizen fitness. E-mail him here.