Supposedly receiving recommended preventative health services will save money in the long run. According to a study in Health Affairs, most Americans don’t get all the recommended preventative health care they should. (HA Article) These services include annual checkups and certain screenings and immunizations. Under federal law, most of these services are supposed to be free of cost-sharing, so there shouldn’t be financial barriers for insured patients. Using data from 2015 and focusing on high-priority recommended services, the researchers found that only 8% of all adults over age 35 received all of them. Women generally did slightly better than men, but there was little difference across age bands. Five percent of these adults got none of the recommended services. On average each person should have received ten services. The most commonly received service was a blood pressure screening, at 90% of adults and least commonly received was shingles vaccine (which doesn’t work for many people and is expensive). Flu vaccines were only received by about half of adults (that may reflect the fact that only older adults are strongly advised to get one) and pneumonia vaccine by almost two-thirds. Cancer screenings had fairly high rates of use. The study was relatively small and based on self-reported survey data, so it likely undercounts service use. A claims data source or an EHR one would likely be more accurate. It is also unclear for many preventative services whether they truly make for better outcomes. They certainly don’t reduce health spending in the short-term; if every adult got all recommended services that would add a fair amount to the nation’s health bill. And it is also unclear who should be responsible for making sure recommended services are received–the patient; the primary care providers; the health plan? Some quality reporting systems use a number of these preventative service receipt measures, so providers and plans may be financially incented to ensure the services reach the patients.