Reimbursement for preventive services: can we construct an equitable system?

Abstract:

:This report examines alternative methods of paying for clinical preventive care services. First, the extent of coverage of preventive health care services in public and private health insurance plans is reviewed. Included in this review are Medicare, Medicaid, health maintenance organizations, and private health insurance plans. Second, four alternative methods for paying for preventive care are discussed. These options are: 1) fee-for-service; 2) a periodic preventive health visit fee; 3) capitation; and 4) a preventive services account. The report concludes with recommendations for constructing an equitable system for increasing access to preventive services. A multi-pronged approach is recommended involving improvements in public and private coverage of these services; development of a periodic preventive health visit fee payment mechanism; initiation of additional research and demonstration efforts designed to determine cost-effectiveness of services and payment approaches; and modifications to the current coding system that would lead to a more appropriate method for reimbursement of preventive care services.

journal_name

J Gen Intern Med

authors

Davis K,Bialek R,Parkinson M,Smith J,Vellozzi C

doi

10.1007/BF02600851

subject

Has Abstract

pub_date

1990-09-01 00:00:00

pages

S93-8

issue

5 Suppl

eissn

0884-8734

issn

1525-1497

journal_volume

5

pub_type

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