Although preventative services such as routine well-care visits and immunizations have often shown to be beneficial in terms of preventing future, more expensive, health care encounters, not all insurance plans offer reimbursement for such things. In addition, health care policies have only recently begun to recognize the “worth” of funding prevention-related services.

Why has funding preventative health care services has taken so long to become a major component of health plans?

What will need to happen to change the prevailing mindset of funding health care services reactively versus proactively from a third-party payer’s and an administrator’s perspective? Why?


Solution Preview

All of business is cost-benefit-analysis. While some HMOs and other insurance carriers are making a profit, others are struggling to figure out how the new Affordable Care Act will impact their business. Polls show that there’s more of an interest in investing in other areas than prevention.

According to discussions at its annual National Health Policy Conference (NHPC) in Washington, D.C. on February 2-3, 2009, AcademyHealth, noted that confusion and vagueness about what terms such as disease prevention, health promotion, community-level prevention, and community-based prevention mean. Also indicated at the conference was the issue of collaboration across fragmented systems and the funding process. Community-based initiatives raise the issue of who is responsible? Who takes leadership, and how should the project be financed?

In Michigan, there is a universal database where those who are immunized are entered into the system and if someone moves their information is easily …

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