Preventive care, also called preventative care, refers to actions patients or health care providers take to prevent or stabilize illness and chronic conditions. The benefits of preventive health care include earlier detection, longer lifespans, better quality of life, and, in many cases, lower costs.
As the population ages, health care is becoming more complex in the United States. According to the CDC journal Preventing Chronic Disease, more than half of all Americans live with chronic health conditions, including heart disease, diabetes, or dementia.
Even more crucially, patients are presenting in clinics and hospitals with compounding health concerns and multiple comorbidities. This can result in higher test costs, longer courses of treatment, and difficulty in pinning down diagnoses.
One way primary care physicians and other providers can help reduce strain on health care systems is to offer preventive care services. In this article, we talk about different forms of preventive care, their pros and cons, and what you can do to make preventive health care a cornerstone of your practice.
Article Highlights
- Preventive care falls into three categories: primary (preventing disease before it occurs, such as vaccines), secondary (catching a future health concern at its earliest stages through screening), and tertiary (managing current, often chronic, conditions).
- In Canada, flu shots for patients over 65 have been estimated to save $45 in health care costs for every $1 spent on immunization programs.
- A rapid review from Public Health Ontario found that the money spent on smoking cessation programs was recuperated in 95% of cases.
- Cost is a leading barrier to preventive care for patients, alongside long referral wait times and stigma.
What is preventive care?
Preventive care covers a broad range of services. Some forms of preventive care are medical interventions, while others focus on patient behavior. Screenings done by care providers can also go a long way toward contextualizing patient health.
Preventive health services fall into three main categories:
| Category | Goal | Examples |
|---|---|---|
| Primary prevention | Prevent disease before it occurs | Vaccines, which protect against infectious disease and can slow its spread, sometimes almost stopping it, as with polio in some parts of the world |
| Secondary prevention | Catch a future health concern at its earliest stages | Cancer screenings and other screening tests: mammograms for breast cancer, prostate checks, and colonoscopies for colon cancer |
| Tertiary prevention | Manage current, often chronic conditions | A daily dose of aspirin to prevent the recurrence of blood clots after a stroke; education on how to manage destructive drinking habits or quit smoking |
Does preventive care save money?
It can seem counterintuitive to invest resources against health problems that haven’t yet arisen. But as our population ages and health care systems become increasingly stressed, proactive care is one easy way to minimize health care costs, from both a financial and a humanitarian perspective.
The fact is that preventive care saves lives. As an added bonus, it can also save money.
Cost savings vary depending on the type of treatment (the prohibitive cost of scans and some drugs, for example, can make health care cost effectiveness relative), but many primary, secondary, and tertiary preventions can save money by reducing hospitalizations and expensive treatments down the road.
We know that a patient who quits smoking may increase their lifespan by 5–7 years on average, but a rapid review from Public Health Ontario also found that the money spent on smoking cessation programs was recuperated in 95% of cases. Considerable health care savings accumulated quickly thereafter, and in many forms: from reduced health care costs due to fewer serious conditions down the road, to lower absenteeism and improved workforce productivity.
Among the most effective prevention measures in both health and cost savings are immunizations. Flu shots prevented an estimated 100,000 hospital visits in the US during the 2019–2020 flu season, according to CDC estimates. In Canada, flu shots for patients over 65 have been estimated to save $45 in health care costs for every $1 spent on immunization programs, according to the Canadian Immunization Guide.
Savings are not the reality across all preventive services. Some more expensive proactive interventions, like prescriptions and scans, can increase health care costs overall. Even when they do seem necessary, there is the additional burden of convincing insurance providers they’re necessary, if they cover the service at all.
We’ll go more into the barriers to preventive health care later on. Despite obstacles, however, proactive care like prevention, when used in combination with reactive treatments, has the potential to improve patient quality of life, reduce certain costs, alleviate strain on the health care system, and help create a more holistic patient care structure.
What are the benefits of preventive health care?
Here are just a few ways preventive services can improve patient care:
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Earlier detection. When it comes to chronic disease, early detection is vital to patient outcomes. Cancer survival rates are substantially higher when the disease is caught early, as Cancer Research UK reports, but early detection of mild cognitive impairment can also significantly drive treatment in cognitive health.
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Longer lifespan. Related to early detection, catching disease early, or preventing it altogether, has the potential to add years to patients’ lives.
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Quality of life. Apart from the improved quality of life that comes with preventing disease before it starts, quality of life considerations can also factor into secondary and tertiary preventive care, like substance use counseling and mental health.
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Prevention of comorbid conditions. Proactively addressing the development of chronic and complicated comorbidities can help reduce the growing strain on our health care system.
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Expanded medical practice. Providers concerned with holistic patient care can turn to prevention as one solid way to expand their services. By making annual wellness visits part of regular health screenings, you can build patient trust and develop a reputation as an attentive and thorough provider of care.
If applicable, confirm insurance coverage for preventive services before offering them to patients. Effective preventive care implementation may rely on cooperation with insurance providers, especially when it comes to more expensive screening tests like scans.
What services count as preventive care?
“Preventive care” covers such a broad array of potential services that it can be hard to know what qualifies. Here are some services that might qualify as effective preventive health care:
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Physical assessments. The most basic elements of a physical exam count as preventive care. You’re already aware of the screening benefits of pressing a stethoscope to a patient’s chest and listening to their breathing. Cardiovascular screening is worthwhile, and so is screening using a wider net. These regular health screenings allow you to detect signs of health problems early.
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Blood tests. Use blood tests to check on much more than iron and glucose levels. Blood tests can feature in preventive measures like genetic screening, diagnostic tests, assessing risk of heart disease, and cancer detection.
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Counseling. We’ve mentioned smoking cessation programs, but counseling can help inform patient behavior on any number of fronts, including substance use and vaccine intake. Behavioral counseling is also a great way to stress the importance of factors like appropriate exercise and living a healthier lifestyle, which can help to manage certain chronic conditions including mental illness and cognitive impairment.
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Questionnaires. Questionnaires screen for mental health concerns, including depression, anxiety, and substance use disorders; neurological concerns like ADHD, autism, and concussion; and even for cognitive deficit. At worst, a questionnaire will provide information to you and your patients about what isn’t a concern; at best, it provides key information for mental health treatment and intervention.
Preventive care for children
Well-child visits are important preventive care opportunities for kids. Apart from monitoring children’s health and development, these appointments provide opportunities for clinical preventive services such as:
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immunizations
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treating lead exposure
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vision and hearing tests
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mental health screening for teens
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STI screening for teens
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and much more
Many health insurance plans cover comprehensive well-child visits. Check the U.S. Department of Health and Human Services’ list of covered clinical preventive services a provider might offer to children.
Why is use of preventive care services so low?
It’s easy for us to advise the implementation of preventive health care, but less easy to know when preventive care is the best option. Below, we discuss some of the barriers to clinical preventive services implementation.
Awareness of these concerns can help both health care providers and patients thoroughly understand their options when choosing a care plan.
Obstacles for providers
Financial considerations
Billing is a central concern for primary care physicians and other health care providers when recommending proactive treatment. While some screening methods like counseling and immunizations save money, more expensive preventive services like scans and certain prescriptions can result in higher costs than reactive treatment services.
Working with Medicaid and other insurance providers may put some preventive care options within reach that otherwise would not be possible. But given that reimbursement guidelines are constantly shifting, it can be difficult to know when health screenings are worth the cost to insurance providers, or to the patient themselves.
Access to sensitive and accurate testing tools
When it comes to screening tools like questionnaires and cognitive function tests, it can be hard to decide on a treatment plan based on vague, subjective, or incomplete data. This is especially true when data fatigue is a leading concern with health care providers. It’s one thing to implement screening tests, but another to parse the best treatment options based on endless metrics.
Obstacles for patients
Financial barriers
As with health care providers, cost is a leading barrier to preventive care with patients. Insurance providers may be reluctant to cover proactive procedures if they don’t appear medically necessary in the way reactive services are. Patients also may not possess the time, energy, skills, or knowledge required to appeal insurance decisions, or may not possess insurance at all.
Long wait and referral times
Referral times for scans and specialists can range from weeks to months. Particularly when patients may not see preventive health care as medically necessary, the thought of waiting so long just to hear from a doctor that nothing is wrong may seem like a waste of time, money, and energy.
Stigma
Certain preventive screenings may pose socio-psychological barriers. Mental health, substance use, and cognitive function tests are at particular risk for associated stigma: a patient may react negatively to the very idea of susceptibility to these less-understood mental health and cognitive conditions.
Making preventive care part of the solution
Though never a one-size-fits-all solution (no amount of programming or conversation is likely to slow the spread of cancer), more accessible forms of preventive care like counseling may help bridge the gap posed by obstacles to providing preventive care.
In other words, holistic patient care may involve providing patients with information. This can include patient education and counseling to provide information and reduce stigma, or straightforward communication on possible preventive services; barriers to those services; possible alternatives; and what patients can do at home to improve their health outcomes.
Leading indicators of preventive care adoption
Apart from education, of both yourself and your patients, research on clinic adoption points to certain factors that can help make preventive care a cornerstone of your practice. Qualities identified again and again in clinics that offered preventive care services include:
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Value-based care. These care structures, where providers are compensated based on patient outcomes rather than fee-per-service, center diverse care methods, distributed care burden, and care transparency while devaluing profits. In other words: when patient outcomes are prioritized, patient outcomes improve.
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Leadership. One way to influence care cultures toward preventive care is to champion preventive care values. Leadership toward a prevention-driven model can look like many things, as a literature review on leadership describes, but some important factors may include:
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Clear vision: Working toward health care focused on patient outcomes.
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Communication: With patients, insurance providers, and other health care practitioners.
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Collaboration: Working with other care providers to influence care culture.
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Education: Of yourself, your patients, and other care providers on preventive care options.
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Fostering leadership in others: Encourage others to champion preventive care with you.
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Measurement tools. Use of screening and measurement tools can give providers extensive information on their patients’ needs in many of the more obscure domains of holistic health care, like mental and cognitive health. If you need to start somewhere, collecting data may help you figure out where to start in holistic care planning.
Final thoughts
Preventive care is a growing concern in health services, with good reason. As our population ages and chronic disease and comorbidities grow increasingly complex, proactive disease control may become a crucial way to reduce strain on our health care system.
Taking a proactive approach to improving holistic care not only supports patients’ long-term health but, in many cases, may also reduce costs over time. Whether focusing on physical screening like blood tests or applying measures like questionnaires, there’s no bad way to implement preventive care as part of holistic care provision.
Written by Mike Battista, Director of Science & Research at Creyos
Mike Battista specializes in brain health, cognition, and neuropsychological testing. He received his PhD in personality and measurement psychology at Western University in 2010 and has been doing fun and useful stuff in the intersection between science and technology ever since.