If Prevention Is the Best Medicine, How Do We Increase Utilization Rates?

It seems like a fairly easy decision: Get your blood pressure checked by a healthcare professional and reduce the chances of developing heart disease or having a stroke. Get a mammogram and add years to your life by detecting breast cancer early.

The advantages of preventive care to stay healthy are clear, but a recent study found that only 8% of people over the age of 35 in the United States have received all the high-priority, recommended preventive screenings and services. Why are so few people participating, and how can we encourage more to do so?
 

What Is Preventive Care?

The purpose of preventive healthcare is to reduce the risks of preventable illnesses and to detect conditions in their earliest and most treatable stages. The goal is to help keep people healthy, rather than to only treat their illnesses.

Recommended preventive care services include blood pressure, diabetes, and cholesterol screenings; well-baby and well-child visits; prenatal and maternity care; colorectal cancer, skin cancer, and breast cancer screenings; immunizations; and screenings for depression, obesity, and substance use. Many of the services can be performed in a primary care office visit.
 

Preventive Care Is Effective If People Use It

Many health problems are chronic conditions that shorten people’s lives, negatively impact their quality of life, and increase their healthcare costs. These conditions often can be prevented or managed through screenings, early intervention, and lifestyle changes.

High blood pressure is one condition that’s easy to identify through preventive care and can have big health impacts if it goes undetected. Uncontrolled high blood pressure can lead to heart disease, stroke, kidney disease, and even vision loss.

Increasing blood pressure screening is good not only for individual people, but also for the broader community. Heart disease and stroke account for about one third of deaths in the United States. The two conditions cost the healthcare system over $215 billion per year and cost employers just under $150 billion per year in lost productivity.
 

What Stops People from Getting Preventive Care?

Cost is one barrier to preventive care. Health plans cover preventive health care at no cost to consumers — no deductibles, copays, cost sharing, or other out-of-pocket costs — as required by the Federal Affordable Care Act. But the 31 million people under the age of 65 without adequate health insurance coverage are left out of this benefit.

Some people opt not to get preventive care because they fear finding out they have a health condition, fear the actual test or service, or distrust healthcare professionals.

Social drivers of health — such as education level, employment, transportation, housing, and community norms — can positively or negatively affect a person’s ability and willingness to seek preventive care.
 

What Can Be Done to Increase the Use of Preventive Care?

Increasing the number of people with health insurance and making preventive care more convenient are two critical paths to increasing preventive care use. Virtual primary care is an emerging way to provide preventive services where, how, and when people want it. A virtual care team conducts an initial health check-in, creates a personalized care plan, and provides a range of services, from chronic condition management to urgent care.

Options to reduce fear or hesitancy while increasing convenience and access could increase use. This includes home screenings, which would help people who are uncomfortable in  clinical settings or who have transportation or time constraints. Home-based tests are a growing alternative to screenings such as colonoscopies. While not as thorough as a colonoscopy, home tests are more user-friendly and less frightening, eliminating complicated preparation and other barriers to care like the need to secure transportation due to sedation, caregiving support, or time off from work.

Another approach to increasing the use of preventive care is to focus on involvement at the community level, where health is created and supported. We can leverage positive messaging through various communities to encourage people to receive recommended services.

Looking holistically at people’s reasons for not getting preventive care can help us address barriers and develop consumer-centered approaches for enabling and encouraging more use of these services.