Designing a high-quality package of preventive services
Clinical preventive services include four types of services: immunizations; screening tests for the
early detection of disease; counseling for health-related behavior change; and chemoprevention,
to prevent disease with drugs. Not all diseases can be prevented, however, and not all preventive
services help patients. Although there is a popular opinion that all preventive care must be
helpful, careful analysis has shown that some preventive services lead to increased false
positives, increased costs, and no net improvement in health.
But literally millions of years of life could be gained by Americans if we used effective
preventive services. Although there is great potential for decreasing the morbidity and mortality
associated with diseases through the use of proven clinical preventive services, coverage of these
services by health plans, insurance programs, and government agencies varies widely. An
important question is which screening tests, immunizations, counseling, and chemoprevention
services should be covered to optimize the health of Americans in the most cost-effective way.