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Most Medical Emergencies Could Have Been Prevented

preventionMuch of preventive health care is now free of charge as long as you get a policy that was sold after the Affordable Care Act became law in 2010. Regular wellness check-ups, mammograms, screenings for cancer and diabetes and other preventive procedures are covered in every year whether you meet the plan’s annual deductible or not.  And, Medicare, along with Medicare Advantage plans, offers recommended preventive services without imposing any out-of-pocket costs, too.

Preventive health care is one way to prevent hospitalization and emergency room visits and that can help with the escalating cost of health care overall.  The lack of preventive health care services is the leading cause of medical emergencies according to a study by Nancy Ray, a MedPAC principal analyst. Conditions such as asthma, diabetes and heart failure, if better monitored, would not lead to hospital admissions at all. Her study showed varied rates of admissions depending on how much preventive health care was available.

Most preventable emergency room visits are for upper respiratory infections or congestive heart failure. When it comes to Medicare beneficiaries, for example, hospitals in states with the lowest emergency room admissions are the same hospitals where preventive health care is most available for people enrolled in Medicare. Thus, preventive health care services appear to have a direct link to reducing the need for emergency room services.

Nancy Ray suggests that going to the doctor for regular wellness check-ups can keep patients out of the E.R. and reduce hospital admissions.  And, we’ve seen for years that people who eat healthy food and get some regular exercise need less medical intervention.

Early detection of disease is a major part of preventive health care, so services like mammograms can be completely covered unless they are billed as being diagnostic as opposed to preventive. At present, 60 percent of emergency room visits and hospitalizations appear to be brought on by a pervasive lack of preventive health care. Annually, Medicare spends no less than $30 billion for treatment that could have been avoided if preventive health care have been available.

Author: Jim McFadden
Jim McFadden has over 11 years of executive-level experience in the health insurance industry, is a youth baseball, softball and football coach, and has one of the worst fantasy football records in the world.

 

 
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