Poor nutrition is a major problem in older Americans. Inadequate intake affects approximately 37 to 40% of community-dwelling individuals over 65 anni.
The vast majority of older Americans have chronic conditions in which nutrition interventions have been demonstrated to be effective in improving health and quality-of-life outcomes.
87% of older Americans have either diabetes, hypertension, dyslipidemia, heart disease or a combination of these chronic diseases.
These conditions all have adverse outcomes that can be ameliorated or reduced with appropriate nutrition intervention.
Yet for the vast majority of Medicare beneficiaries, nutrition therapy by a nutrition professional is not a covered benefit.
Although varying amounts of basic nutrition services are included in reimbursement payments in hospital, home health, and post-acute care settings, services have been largely inconsistent or inadequate to meet the needs of the growing elderly population.
The Medicare program has traditionally not covered preventive services. Nutrition therapy in the ambulatory or outpatient setting has been considered a preventive service and, therefore, given its original intent to provide only reasonable and necessary services for the diagnosis and treatment of disease, Medicare has explicitly not covered nutrition therapy, or any other type of health education or counseling.
In 1980 Congress approved its 1st exception to the exclusion of preventive services by approving coverage for the pneumococcal pneumonia vaccine.
In 1997, recognizing the need for education and counseling in the management of diabetes, Congress approved Medicare coverage for diabetes self-management training as part of the Balanced Budget Act.
In addition to the recent coverage for diabetes education, the Balanced Budget Act of 1997 also required that the Department of Health and Human Services contract with the National Academy of Sciences, Institute of Medicine to examine the benefits and costs associated with extending Medicare coverage for certain preventive and other services.
The services specifically targeted for examination included screening for skin cancer; medically necessary dental services; elimination of time restrictions on coverage for immunosuppressive drugs after transplants; routine patient care for beneficiaries enrolled in approved clinical trials; and nutrition therapy, including the services of a registered dietitian.
This report addresses the benefits and costs associated with extending Medicare coverage specifically for nutrition therapy.
Have a healthy holiday weekend, Keep the Faith!