As the population ages, healthcare is becoming more complex in the United States. More than half of all Americans struggle with chronic health conditions, including heart disease, diabetes, and 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 providers can help reduce strain on healthcare 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 healthcare a cornerstone of your practice.
What Is Preventive Care?
Preventive care, also called preventative care, is a broad term, referring to actions patients or healthcare providers can undertake to help prevent or stabilize disease or chronic conditions.
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:
- Primary prevention refers to services designed to prevent disease before it occurs. Vaccinations are prime examples of primary prevention, often slowing—sometimes almost stopping, as with polio in some parts of the world—the spread of a disease. Other examples of primary prevention include general health practices, such as healthy eating and exercise, which can be beneficial in the context of conditions such as mild cognitive impairment and diabetes.
- Secondary prevention refers to preventive services that might help catch a future health concern as early as possible. This often takes the form of screening tests. Mammograms, prostate checks, and colonoscopies are common examples of secondary prevention services.
- Tertiary prevention refers to care that helps manage current, often chronic conditions. For example, a stroke patient might take a daily dose of aspirin to prevent the recurrence of blood clots. Tertiary prevention can also include education, such as on how patients can manage destructive drinking habits or quit smoking.
Why Preventive Care Over Treatment?
It can seem counterintuitive to invest resources to combat health problems that haven’t yet arisen. But as our population ages and healthcare systems become increasingly stressed, proactive care is one way to minimize healthcare costs—from both a financial and humanitarian perspective.
The fact is that preventive care saves lives. As an added bonus, it can also save money.
The Costs—and Savings—of Preventive Care Services
Though cost savings vary depending on the type of treatment—the prohibitive cost of medical scans and some drugs, for example, can make healthcare cost effectiveness relative—many primary, secondary, and tertiary preventions can save money by reducing hospitalizations and expensive treatments down the road.
How much? As one study states, more than 60% of the $2.5 trillion medical care costs is attributed to chronic conditions. These costs have only risen since they were measured in 2009.
We know that a patient who quits smoking may increase their lifespan by 5-7 years on average, but one Ontario study also found that the money spent on smoking cessation programs was recuperated in 95% of cases. Considerable healthcare savings accumulated quickly thereafter, and in many forms—from reduced healthcare costs due to fewer serious conditions later in life, to improved economic productivity resulting from fewer sick days.
Among the most effective prevention measures in both health and cost savings are immunizations. Not only did flu shots prevent an estimated 100,000 hospital visits in the US during the 2019–2020 flu season, flu shots for Canadian patients over 65 have been estimated to save $45 in healthcare costs for every $1 spent on immunization programs.
However, savings are not the reality across all preventive services. Some more expensive proactive interventions, like prescriptions and scans, can increase healthcare costs overall. Even when preventive services 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 healthcare 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 healthcare system, and help create a more holistic patient care process.
What Are the Health Benefits of Preventive Care?
Here are just a few ways preventive services can improve patient care:
- Earlier detection. When it comes to chronic disease, little is more important to patient outcomes than early detection. It’s common knowledge that rates of cancer survival are substantially higher when the disease is caught early, but early detection of mild cognitive impairment can also significantly improve cognitive health outcomes.
- Longer lifespan. Related to early detection, catching disease early—or preventing it altogether—has the potential to add years to patients’ lives.
- 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.
- Prevention of comorbid conditions. Proactively addressing the development of chronic and complicated comorbidities can help patients achieve a better quality of life and reduce their symptoms.
- Expanded medical practice. Providers can turn to prevention as one solid way to expand their services. By making annual wellness checks part of regular health screenings, you can build patient trust—and develop a reputation as an attentive and thorough provider of care.
If applicable, consider insurance before offering preventive services to patients. Effective preventive care implementation may rely on cooperation with insurance providers, especially when it comes to more expensive screening tests like scans. However, some cost-effective options, such as computerized neuropsychological assessments, may be reimbursable in many circumstances.
Understanding 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 healthcare:
- Physical assessments. The most basic elements of a physical exam count as preventative care. Physicians are already aware of the screening benefits of pressing a stethoscope to a patient’s chest and listening to their breathing. Cardiovascular screening is also worthwhile. These regular health screenings allow clinicians to detect signs of health problems early.
- Blood tests. Blood tests can be used 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.
- 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.
- Psychological and health questionnaires. Questionnaires can help screen for mental health concerns, including depression, anxiety, and substance use disorders; neurodevelopmental concerns like ADHD and autism; and even for disruptions to daily living that can result from cognitive deficits. 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 early treatment and intervention.
Preventive Care for Children
Preventive healthcare visits for children, also called 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:
- treating lead exposure
- vision and hearing tests
- mental health screening for teens
- STI screening for teens
- and much more
Many health insurance plans cover comprehensive well-child visits. Check this complete list of clinical preventive services covered in the U.S. that a provider might offer to children.
Why Is Use of Preventive Care Services So Low?
It’s easy to see the benefits of implementing preventive healthcare, but less easy to know when preventive care is the best option. Below, we discuss some of the barriers to implementing clinical preventive services.
Awareness of these concerns can help both healthcare providers and patients thoroughly understand their options when choosing a care plan.
1. Obstacles to Providers
a. Financial considerations
Billing is a central concern for healthcare 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 for the healthcare provider 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, healthcare providers—or the patient themselves. Cognitive screening tools may charge the provider for every test administration, which can reduce profits, especially for preventive care where repeated testing can reveal longitudinal trends.
b. Access to sensitive and accurate testing tools
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 healthcare providers. That’s where screening tools like questionnaires and cognitive function tests that are comprehensive, scientifically-validated, and easy to interpret come into play.
2. Obstacles to Patients
a. Financial barriers
As with healthcare 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.
b. Long wait times and referral times
Referral times for scans and specialists can range from weeks to months. Particularly when patients may not see preventive healthcare as medically necessary, the thought of waiting for so long just to be told there’s nothing wrong may seem like a waste of time, money, and energy.
Socio-psychological factors may create a barrier between patients and certain preventive screenings. 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.
Make 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, preventive patient care may involve providing patients with information. This can include patient education and counseling to provide information and reduce stigma, straightforward communication on possible preventive services, removal of barriers to those services, and what patients can do at home to improve their health outcomes.
Leading Indicators of Preventive Care Service Adoption
Apart from education—both of yourself and your patients—there are 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:
- 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!
- Leadership. One way to influence care cultures toward preventive care is to champion preventative care values. Leadership toward a prevention-driven model can look like many things, but some important factors may include:
- Clear vision: Working toward healthcare focused on patient outcomes.
- Communication: With patients, insurance providers, and other healthcare practitioners.
- Collaboration: Working with other care providers to influence care culture.
- Education: Of yourself, your patients, and other care providers on preventive care options.
- Fostering leadership in others: Encourage others to champion preventive care with you!
- 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 healthcare, 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. Today, there are measurement tools that fit measurement tools that fit seamlessly into current healthcare practices. They represent a practical step toward preventive care that works within today’s healthcare system.
Interested in measuring cognitive performance?
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 healthcare system.
Taking a proactive approach to improving holistic care not only improves patient outcomes but, in many cases, it may reduce costs in the long run. Whether focusing on physical screening like blood tests or applying measures like questionnaires, there are many beneficial ways to implement preventive care as part of total patient care provision.