The Centers for Disease Control and Prevention (CDC) regards clinical preventive services as public health priorities in its role as the nation's health protection agency. To that end, CDC conducted a study of such services for U.S. adults during the timeframe of 2007-2010, prior to enactment of the Affordable Care Act (ACA), which provided approximately 54 million Americans with at least one new free preventive service through their private health insurance plans.
According to CDC's study, released June 14, only about half of U.S. adults received selected preventive services such as screenings, consultations and prescriptions, from a health care professional before 2010.
The report provides baseline data on the use of selected adult preventive services, including aspirin or other blood-thinning therapies, controlling blood pressure, screening for and controlling high cholesterol, and ending tobacco use.
Among the report's findings:
- Of patients with heart disease primarily affecting the blood vessels, only 47 percent were prescribed the recommended daily use of aspirin during visits to their doctors.
- The U.S. Preventive Services Task Force guidelines for the prevention of high blood pressure state that adults 18 years old and older with high blood pressure should receive a clinical treatment plan that might include medications and monthly follow-up visits until healthy blood pressure is achieved, yet less than half (44 percent) of people with high blood pressure had it under control.
- Similarly, despite strong evidence that screening and treating for high cholesterol reduces sickness and death due to heart disease, about 33.4 percent of men and 25.6 percent of women were not screened during the preceding five years. Of those adults identified with high levels of LDL (bad) cholesterol, only about 32 percent of men and 32 percent of women had it under control.
- According to data from the National Ambulatory Medical Care Survey and the National Health Interview Summary, fewer than 1 in 13 tobacco users were prescribed medications to help them end their tobacco use when they saw their doctor.
"Clinical preventive services prevent heart attack, stroke, cancer and other diseases and save lives," said CDC Director Thomas R. Frieden, MD, MPH. "This report provides a snapshot of preventive services for U.S. adults before 2010. As we look to the future, we can track how our nation’s health is progressing through better prevention in health care."
The data could change in the future because of certain ACA provisions. These include a requirement for new private health insurance plans to cover recommended preventive services with no cost-sharing. The health care law also requires coverage for a new annual wellness visit under Medicare and eliminates cost-sharing for recommended preventive services provided to Medicare beneficiaries. The law also gives state Medicaid programs financial incentives to cover preventive services for adults and supports initiatives to improve public understanding of the benefits of preventive services.
CDC estimates that 32.5 million people with Medicare received at least one free preventive benefit in 2011, including the new Annual Wellness Visit.
The agency said it is working with medical systems and health provider organizations to increase the number of physicians who routinely screen patients for tobacco use and provide advice for how to end tobacco use, establish systems of referral to tobacco quit lines as well as other community resources, and reduce economic barriers by removing copayments and including quit line coaching and cessation medication as covered benefits.
States and communities that receive CDC’s Community Transformation Grants are working to promote prevention and control of high blood pressure and high cholesterol.
CDC also helps state Medicaid programs to develop systems that identify people who are at risk for various health conditions due to age and behaviors. The programs ensure that those people get screened, and that patients with abnormal screening test results are quickly referred to a medical provider.
The newly released report also provides baseline data on diabetes management, colon and breast cancer screening, HIV testing and influenza vaccination.