The  PRO program, which is designed to monitor and improve quality of care  for Medicare beneficiaries, currently includes the goal of increasing the  use of flu and pneumonia immunizations, as well as breast cancer  screening, in each state. The Use of Individual Preventive Services Has Increased over Time but a Minority Receive Multiple Services

Information on usage for 4 of the 10 preventive services covered under  Medicare is available in the data we used—immunizations against  pneumonia and flu and screening for cervical and breast cancer. For example,  in most states, screening rates for breast and cervical cancer were higher  than rates for colorectal screens. Similarly, about 70 percent of whites and “other” ethnic groups received  flu shots during the year compared to 49 percent of African Americans. For income and education, in  general, as income and education rose, the rates at which individuals used  preventive services also increased. Efforts Under Way to Increase Use of Some Preventive Services

CMS has studied various types of interventions to increase the use of  preventive services among seniors. These and other  interventions found to be effective follow. For breast cancer  screening, efforts are focusing on developing integrated reminder systems,  such as chart stickers or computer-based alerts that physicians’ offices can  use to contact patients on a timely basis. CMS officials expect  information on the results by the summer of 2002.
Why GAO Did This Study

Preventive medicine, including immunizations for many diseases and screening for some types of cancer, holds the promise to extend and improve the quality of life for millions of Americans. Medicare now covers three preventive services for immunizations and three for screenings, and the Centers for Medicare and Medicaid Services (CMS) sponsors "interventions" to increase the use of preventive services.

What GAO Found

GAO found that the use of preventive services varies widely by service, state, ethnic group, income, and education. The greatest differences among ethnic groups were for immunization rates. Cancer screening rates tended to differ according to income and education level. CMS pays for interventions that promote breast cancer screenings and pneumonia and flu shots. Most of the techniques being used, such as reminder systems that medical offices can use to alert doctors and patients to needed cancer screenings, have been effective. CMS is evaluating what its current efforts have accomplished and expects the results later this year.