Medicare Preventive Services Home Healthcare Providers Should Know

medicare preventative care

Catching a disease early is a good thing for patients, healthcare systems, and payors. Preventing a disease from manifesting with preventive measures and screenings is one of the best things you can do to reduce healthcare costs and close care gaps.

Medicare health plans offer different preventive services to help drive down the cost of healthcare. Read on for a list of some of the Medicare Preventive Services offered with various Medicare plans, as well as solutions that make offering these preventive services to patients even easier.

What are Medicare Preventive Services?

Medicare preventive services are provided by Medicare plans to detect health problems early. Treating a disease in its early stages leads to more successful treatments and better patient outcomes. The Medicare preventive services that are available to a person depend on what type of Medicare plan they have. 

What is the Purpose of Preventative Screenings and Health Risk Assessments Within Medicare Advantage Plans?

Medicare preventative care, as well as the health risk assessments that often come as a part of Medicare preventive services, is meant to lower overall costs for Medicare providers, such as Medicare Advantage, and in-home healthcare providers.

The cost of prevention vs treatment is debated and heavily studied, but this study performed by the National Academy of Sciences estimates that a “90% delivery rate of primary preventive services could reduce [health] expenditures by… $1.8 billion.” While the exact numbers remain estimates, the CDC asserts that it is far better to prevent diseases from manifesting rather than treat them after they have been discovered.

The stark difference in cost based on when a disease is found and managed (or whether it is found at all) is a primary reason Medicare preventive care is so important. Below we detail some of the Medicare preventive services that Medicare Advantage Plans and in-home health services can take advantage of in order to boost preventive screenings and lower costs.

What are Examples of Preventive Services?

1. Cancer Screenings

Medicare preventive services for cancer are extensive. They offer coverage for breast cancer screenings, prostate cancer screenings, colon cancer screenings, and more.

And some of these screenings don’t even have to be performed in a doctor’s office anymore. Solutions like Cologuard, an at-home colon cancer screening test, help Medicare Advantage Plans and in-home healthcare providers get patients the preventive testing they need in an easier way. 

Newer tests, like imaware prostate cancer screening test, use biomarkers in the blood to determine how at-risk someone is for developing prostate cancer.

2. Cardiovascular Disease Screening

Medicare preventive services for cardiovascular disease include screenings that check cholesterol and other blood fat levels, as high cholesterol can affect your risk for heart disease and stroke.

There are at-home screenings available as preventative tests for cardiovascular diseases as well. The company imaware also offers a baseline heart health test that measures biomarkers that show a patient’s risk for certain heart diseases.

3. Diabetic Screenings

Medicare preventive services for those at risk of developing diabetes include a blood screening test to check for risk factors. For those with diabetes, Medicare covers educational training to help individuals manage their diabetes.

Part B of Medicare covers additional services for diabetic individuals, such as yearly screenings for diabetic retinopathy. Part B is included as a part of Medicare Advantage Plans. 

A solution like IRIS helps increase the number of diabetic patients receiving preventative screenings by enabling in-home health providers to perform diabetic retinopathy exams. This not only ensures patients receive yearly screenings, but it also reduces costs for payors, providers, and Medicare Advantage Plans by lessening the need for retroactive disease management and treatment. 

4. Yearly Wellness Visits

Medicare preventive services include a yearly wellness check. This check can include things such as a health risk assessment, a review of medical and family history, and personalized health advice.

How IRIS Can Be a Part of Medicare Preventative Care and Health Risk Assessments

A study performed by the CDC shows that healthcare payors, such as Medicare Advantage Plans, play an essential role in boosting the number of preventive screenings patients undergo. Making Medicare preventive services more convenient and accessible for patients reduces healthcare costs by eliminating a major barrier to preventative care.

IRIS helps prevent blindness caused by late-stage diabetic retinopathy by seamlessly integrating with Medicare Advantage Plans and in-home healthcare providers. It allows in-home healthcare providers to administer a diabetic retinopathy exam in a patient’s home, meaning a patient doesn’t have to schedule and attend a separate ophthalmology appointment for an eye exam.  

Conclusion

Yearly diabetic retinopathy exams are crucial for diabetic patients because diabetic retinopathy is the most treatable when a patient has no symptoms. IRIS is a partner for in-home healthcare providers and Medicare Advantage Plans alike in helping reduce the number of vision losses caused by diabetic retinopathy going undetected for too long.

Contact us to learn how we can partner together to reduce healthcare costs and close care gaps, or head over to our ROI calculator to see how much you could save with IRIS.

FAQS:

Which Medicare part covers preventive services?

Different Medicare preventive services are available for different levels of Medicare coverage. Those covered under Original Medicare Plans will have different Medicare preventive care options available to them than those covered on Medicare Advantage Plans.

What preventive services do Medicare Advantage Plans cover? 

Medicare Advantage Plans cover all Part A and Part B benefits as well as fitness programs, and some vision, hearing, and dental services (like routine checkups or cleanings). 


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