Navigating the Health Care System
Advice Columns from Dr. Carolyn ClancyFormer AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.
Resources to Help You Stay Healthy in the New YearBy Carolyn M. Clancy, M.D.
As the New Year gets closer, it's a good time to think about how to stay healthy in 2013.
One important way to do that is by getting regular medical checkups. Depending on your age and health needs, these visits may include certain types of preventive and screening tests.
If Medicare covers you or a family member, you may have already taken advantage of some of the new benefits provided under the Affordable Care Act (ACA). These benefits include a "Welcome to Medicare" annual wellness visit at no cost to people who are new to the program.
The one-time annual wellness visit can give your health care provider a good picture of your overall health. During that time, he or she can also offer the education you may need to improve your health. During 2012, an estimated 2.5 million people covered by Medicare received a wellness visit.
The ACA also makes a wide range of preventive and screening tests more available to patients by no longer requiring Medicare Part B co-insurance and deductibles payments.
Results of screenings can, for example, tell if you need to start medicines or change your diet to manage diabetes or high blood pressure. This year, more than 23 million people with Medicare received one or more preventive and screening services, according to the Department of Health and Human Services.
No-cost preventive and screenings tests available under the ACA include:
- Bone mass measurement (also known as bone density test): Covered every 2 years.
- Cholesterol and other cardiovascular screening: Tests for cholesterol, lipid, and triglyceride levels are covered every 5 years.
- Colorectal cancer screening: Medicare covers colonoscopy tests once every 2 years for people at high risk; otherwise, once every 10 years.
- Diabetes screening: Up to two fasting blood glucose tests are covered each year.
- Flu shot: Medicare covers a shot once per flu season in the fall or winter.
- Mammogram: Screening mammograms are covered once every 12 months. Diagnostic mammograms are covered when medically necessary.
- Prostate cancer screening: Medicare covers a digital rectal exam once each year; prostate specific antigen (PSA) tests are covered once each year.
If a test identifies a health condition that needs medicines or another kind of treatment, you can learn more about your options with consumer summaries developed as part of AHRQ's Effective Health Care Program. Forty publications are available to consumers for free. They describe in plain English the benefits and risks of different treatments for various health conditions.
They do not replace your health care team's recommendations. However, they give information on the pros and cons of specific treatment options that can help you decide the best approach for you. Many of the consumer summaries are also available in Spanish.
For example, the publication on medicines for Type 2 diabetes describes how diabetes medicines (generic and brand names) work to control blood sugar. Charts show benefits and possible side effects of different types of medicines taken alone or if two are taken together. The summary also includes price information for each generic and brand name drug for a one-month supply.
Another consumer summary helps patients decide how to choose the best type of medicine for high blood pressure. Treating high blood pressure is important, because it can lead to heart disease, heart attack, kidney disease, and stroke. The publication covers the benefits and possible risks of 3 types of medicines for high blood pressure and how they compare with each other. It also includes price information for each generic and brand name drug for a one-month supply.
Another recent consumer summary helps patients learn how to check their blood pressure at home.
Make a New Year's resolution to stay on top of your health needs. You will find many resources to help you make smart decisions.
I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.
Agency for Healthcare Research and Quality
AHRQ's Effective Health Care Program: Research Summaries for Consumers, Clinicians, and Policymakers
Medicines for Type 2 Diabetes: A Review of the Research for Adults: Consumer Summary
Choosing Medicines for High Blood Pressure: A Review of the Research on ACEIs, ARBs, and DRIs
Measuring Your Blood Pressure at Home: A Review of the Resources for Adults
U.S. Department of Health and Human Services
Welcome to Medicare visit: Medicare.gov
Preventive and Screening Services: Medicare.gov
People with Medicare save $5 billion on prescription drugs because of health law. December 3, 2012.