Enhancing Access to Preventive Services in Underserved Communities

The Power of Preventive Care

Access to preventive care¹ is crucial for avoiding and detecting serious illnesses, managing the burden of chronic diseases, improving long-term health outcomes and reducing total costs for patients and the broader healthcare system. As such, CareFirst BlueCross BlueShield (CareFirst) is committed to ensuring that our members have access to clinically appropriate preventive services.

Approximately 50% of adults in the U.S. have at least one chronic condition, such as diabetes, heart disease or obesity. The CDC Foundation, an independent nonprofit created by Congress to mobilize support for the Centers for Disease Control and Prevention’s (CDC) critical health protection work, reports chronic diseases are responsible for 7 of 10 deaths each year and account for 86% of the country’s healthcare costs. Ensuring access to preventive care, including screenings and lab tests, can reduce the risk and severity of chronic diseases and improve health outcomes at the individual and population levels. Counseling on topics like smoking, weight loss and healthy eating can improve overall wellness and prevent the onset of chronic disease. Investing in prevention can also lead to significant cost savings by decreasing the need for more expensive treatments and hospitalizations, leading to a more sustainable healthcare system that effectively allocates resources.

Finally, improving access to prevention and associated primary care can play a role in advancing health equity by bringing health services closer to communities and removing economic and other barriers to ensure accessible, high-quality care for the entire population.

Barriers to Preventive Care Use

Some patients may not seek preventive services out of concern about cost. Even though many initial screenings, tests and other preventive services are covered by insurance without cost-sharing as required by the Affordable Care Act (ACA), patients may not be aware they are eligible for these services or decide not to pursue them because follow-up care often includes out-of-pocket costs. Additionally, ongoing legal challenges to the ACA preventive services provision could result in changes to coverage of preventive services and associated cost-sharing.

Geographic limitations are also a significant barrier for many individuals, especially those in rural and low-income communities, where there may be a limited number of providers. Residents in these areas may need to travel longer distances for care, posing special challenges for the elderly and those with limited mobility. Even patients in urban areas may lack access to reliable transportation, discouraging patients from seeking preventive health consultations, increasing the risk of developing avoidable health issues. These access challenges, often the result of health-related social needs, exacerbate underlying health disparities. 

Cultural and social factors, such as mistrust and distrust in the healthcare system or lack of health literacy, can also hinder people from accessing preventive care. Other reasons for not seeking or delaying preventive care include not being able to take time off from work and perceived stigma related to seeking care, particularly for behavioral health services. Given these varied factors, a multi-pronged approach is needed to ensure individuals have knowledge of and access to necessary preventive services. 

Prioritizing Preventive Care for a Healthier, More Equitable Future

CareFirst is committed to enhancing access to preventive services including through the following:

• CareFirst launched CloseKnit in 2021 as a virtual primary care platform providing 24/7 access to doctors, nurses and therapists through a user-friendly app, offering real-time urgent and preventive care anytime, anywhere. As a virtual-first Advanced Primary Care practice, CloseKnit delivers preventive services like screenings, immunizations and chronic disease management. CloseKnit supplements virtual visits with Bluetooth-enabled devices, such as pulse oximeters and blood pressure cuffs, to assist with preventive care encounters and chronic disease management. In the first 10 months of 2024, CloseKnit completed over 3,000 well visits and administered over 300 immunizations, including COVID-19 and flu vaccines.
• CareFirst’s Community Engagement Team (CE Team) delivers essential health and wellness services directly to communities through local centers, improving access to preventive care. Through September 2024, CareFirst hosted nearly 80 events, reaching over 4,200 participants. At health fairs, the CE Team provides services such as flu and COVID-19 vaccines, blood pressure screenings, Narcan training, STI/HIV testing and dental screenings. These efforts, in partnership with local nonprofits, also support CareFirst’s commitment to enhancing health literacy, supporting healthcare navigation and promoting healthy behaviors. Also, in October 2024, CareFirst opened a community hub for health and wellness resources, including free fitness and health education classes, at its new workspace in West Baltimore. 
• CareFirst believes we must improve access to healthcare providers in rural areas by encouraging healthcare professionals to practice in these regions. We support federal and local initiatives to strengthen rural healthcare networks and ensure that underserved communities receive the resources they need.

At CareFirst, we envision a future in which individuals in our jurisdictions have access to necessary care regardless of where they reside. By removing obstacles to essential preventive care and bringing those services closer to our communities, we empower individuals to lead healthier lives and create a more equitable healthcare system for all. We urge policymakers at all levels to support broader and more equitable access to preventive services and we encourage other like-minded community organizations to join us in our efforts.

¹Preventive care encompasses a broad array of services including routine physical exams, screening tests to identify individuals at high risk of disease onset, vaccines to prevent disease, education and counseling to help patients make informed health decisions, and lab work to understand how well the body is functioning.