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Extending Medicare Coverage for Preventive and Other Services
parts of the body are considered less germane to the health of Medicare beneficiaries than others.
Chapter 2 reviews the methods and principles that guided the committee in its assessment of the “benefits and costs to Medicare” of extending coverage. More specific information about methods is provided in the chapters and appendixes examining specific coverage topics.
Chapters 3, 4, and 5 focus, respectively, on screening for skin cancer, medically necessary dental services, and immunosuppressive drugs for transplant patients. Each is written with the expectation that it might be read with little or no reference to this introduction or to other chapters of the report, so some background material that might otherwise have been included in this chapter (e.g., definitions) is deferred and some material is repeated in all three chapters. These three chapters review current Medicare coverage; provide background information on the clinical problems being considered and the burden of illness they cause; describe the specific clinical interventions that were analyzed; and summarize the literature on the benefits and harms of the interventions. They also present estimates of the five-year cost to Medicare of covering the interventions.
Chapter 6 compares current Medicare coverage of preventive services with the recommendations on clinical preventive services published by the U.S. Preventive Services Task Force. It more generally considers the processes for making coverage decisions about preventive and other services and the adequacy of the scientific, procedural, and organizational infrastructure for coverage decisionmaking.
Finally, Appendixes B, C, and D include background papers commissioned by the committee to provide detailed reviews of the scientific literature related to the topics considered in Chapters 3, 4, and 5. Appendix E provides a more detailed discussion of the Medicare cost estimates used by the committee.