Preventive services inconsistent in Medicare visits: 30% did not receive an influenza vaccine.(Practice Trends)

Relatively few Medicare beneficiaries get all of the preventive services they need at the physician's office, the General Accounting Office reports.

Most beneficiaries visit a physician several times a year and get some preventive services. However, in 2000, 30% did not receive an influenza vaccination and 37% had never had a pneumonia vaccination, the GAO concluded from its review of four national surveys and data from rive Medicare Plus Choice plans.

The House Energy and Commerce Subcommittee on Oversight and Investigations had asked the GAO to follow up on the recommended preventive services that beneficiaries were receiving at office visits. As part of its research, the GAO also interviewed federal health officials and reviewed documents on Medicare demonstrations related to preventive services.

It's unclear whether physician reimbursement is the primary cause of this shortfall in preventive care, John DuMoulin, director of regulatory and insurer affairs with the American College of Physicians, told this newspaper. The Centers for Medicare and Medicaid Services several years ago actually increased the payment rates for immunizations, so low reimbursement is less of a factor than it used to be, he said.

The report found that relatively few beneficiaries received the full range of needed preventive services. For example, 91% of female Medicare beneficiaries received at least one preventive service, but only 10% were screened for cervical, breast, and colon cancer and also immunized against influenza and pneumonia.

Many beneficiaries aren't even aware that they have conditions that preventive services are meant to detect, the GAO report said. One survey from the Centers for Disease Control and Prevention found that of the beneficiaries who had elevated blood pressure at the time of an ...