Reimbursement for preventive services - Can we construct an equitable system?

Karen Davis, Ronald Bialek, Michael Parkinson, Jeanette Smith, Claudia Vellozzi

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)S93-S98
JournalJournal of general internal medicine
Volume5
Issue number2 Supplement
DOIs
StatePublished - Sep 1 1990

Keywords

  • billing
  • cost-effectiveness
  • coverage
  • preventive services
  • reimbursement

ASJC Scopus subject areas

  • Internal Medicine

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