Preventative health plays big role in reforms

Taking good care of yourself and seeing your doctor regularly is good for your health and for your pocketbook, health experts say.

It’s also a key component of the Affordable Care Act, which mandates all health insurance plans — including those from employer benefits and those sold on the new marketplaces — to cover preventive health care services at no cost to you.

The idea is that by keeping yourself healthy through preventive measures such as diet and exercise, blood pressure and cholesterol tests, mammograms, colonoscopies and other screenings, you’ll stand a better chance at avoiding costly, life-threatening chronic diseases in the years ahead.

“We know that about 50 percent of your health is determined by your daily habits; that’s why we encourage all citizens to live a healthy lifestyle,” Montgomery County Health Commissioner James Gross said. “We are still trying to emphasize with our community the role of tobacco use in premature deaths, for instance. Even today, one in five deaths in our county can be traced back to tobacco use of some type.”

Gross is one of three local leaders chairing the Montgomery County Affordable Care Act Task Force that was established earlier this year by the Montgomery County commissioners. He said one of the task force’s objectives is to study the county’s clinical capacity for meeting the added demand placed on the local health care system by the ACA.

“We do know at this point that we need to bolster our capacity in the county to meet the demands of our vulnerable population,” he said.

Leaders at the Rocking Horse Community Health Center in Springfield, which provides comprehensive health care services to children and adults alike, have already started boosting its staff to meet an expected increase of about 5,000 more patient visits next year. The center currently serves more than 13,500 patients with 56,000 visits per year.

“We decided we would add one new provider (a physician or nurse practitioner) every quarter next year to meet the need,” said Dr. Yamini Teegala, a family physician with the center.

Rocking Horse, which treats people of all ages and is federally qualified health center, also has added a staff member to help the uninsured enroll in plans through the ACA’s health insurance marketplace.

The center has had some success, Teegala said, in getting its patients to focus on prevention and responsibility for their health. It does that, she said, by building a good relationship through counseling and education, being flexible with appointment times and, for the chronically ill, not refilling prescriptions unless the patient has been seen at the center within the past three months.

Dr. Robert Lerer, Butler County health commissioner and a local pediatrician, said patients can make the most of their medical visits by being prepared. Write some notes at least a day in advance, he said. List all medical conditions and if symptoms have improved or gotten worse; list all medications, vitamins and supplements you’re taking and if the dosages have changed. All of this makes the medical interview with the nurse prior to the physician meeting more efficient.

“And probably most important is to bring along a list of questions,” Lerer said.

The Affordable Care Act’s marketplace plans and many other health plans must cover a long list of preventive services without charging you a co-payment or coinsurance, even if you haven’t met your deductible. It applies only when these services are delivered by a network provider.

Some types of services that are covered include diet counseling, cholesterol screenings and mammograms for adults. For children, the preventative services covered include hearing and vision tests, immunizations, autism screenings and behavioral assessments.

For more information and a comprehensive list of services, visit HealthCare.gov/prevention.