CDC sheds incriminating light on health insurers' preventive services

September 12, 2014 | By Diana Manos

A new federal study could bring down some heat on insurers that don't comply with the Affordable Care Act's requirements for preventive care.

The Centers for Disease Control and Prevention (CDC) tracks how well insurers provide preventive services to children under the new law and in the second in a series of ongoing investigations, did not like what it found.

"Millions of infants, children and adolescents in the United States did not receive key clinical preventive services," CDC officials announced.

In addition, the CDC found huge dispcrepancies in care, leading to health disparities. Uninsured children, for example, were not as likely as insured children to receive certain preventive services and Hispanic children were less likely than non-Hispanic children to report vision screening.

The study also found that approximately one in four (24 percent) outpatient clinic visits for preventive care made by 3- to 17-year-olds during 2009-2010 had no documentation of blood pressure measurement.

Other findings included:

In 2009, more than half of children and adolescents did not visit the dentist in the previous year and nearly nine of 10 children and adolescents did not receive a dental sealant or a topical fluoride application in the past year, although both are strongly recommended to prevent tooth decay.
Nearly half of girls in the 13-17 years age grup did not received their recommended first dose of HPV vaccine in 2011 to protect against cervical cancer.
About one in three visits to outpatient clinics by adolescents and young adults ages 11-21 during 2004-2010 did not include a note in the patient files about tobacco use and 80 percent of those who were positive for tobacco use did not receive guidance on quitting.

"The Affordable Care Act requires new health insurance plans to provide certain clinical preventive services at no additional cost--with no copays or deductibles," said Lorraine Yeung, M.D., medical epidemiologist with CDC's National Center on Birth Defects and Developmental Disabilities. "Parents need to know that many clinical preventive services for their children, such as screening and vaccination, are available for free with many health plans."

Many insurance companies embrace preventive care, however. A report released earlier this year by The Blue Cross Blue Shield Association show plans spend more than $65 million a year in value-based payment programs that have a high return on investment. Moreover, Blue Cross plans have seen improvements in preventive care, including better diabetes control and an increase in screenings and immunizations, FierceHealthPayer previously reported.

To learn more:
- read the CDC statement
- check out the CDC report (.pdf)
- here's the BCBS Association study (.pdf)