Prevention First: Turning Health Goals into Everyday Care

When health care and policy leaders talk about improving health, prevention is always part of the conversation. Discussion about disease prevention, timely diagnoses, and healthy lifestyle behaviors is common. These goals are both practical and hopeful, but an important question remains: how do these goals translate into everyday care? One powerful answer lies in how we assess the quality of preventive care.

The Centers for Medicare & Medicaid Services (CMS) plays a major role in shaping health care across the country. CMS sets national priorities and measurement strategy that guide the development and use of health care measures. CMS partners with the Partnership for Quality Measurement (PQM) to ensure the measures used in its programs are safe, meaningful, and patient-centered. 

When prevention is measured effectively, it becomes part of everyday care. When it is not, prevention can fade into the background, especially in communities that already face barriers to care.

Prevention is Powerful, But it Takes Time

Prevention is more than a checklist of screenings – it is about reducing risk before illness begins. Preventive efforts might include immunizations, medication management, and helping people live well with chronic conditions over time. Prevention also happens beyond the doctor’s office. Nutrition programs, smoking cessation, well-being initiatives, and other community efforts play a major role in keeping people healthy. These efforts are harder to measure because they unfold over time and across multiple care settings, not in a single, easily documented encounter. Without systems designed to accurately measure prevention, it can be easy to overlook as a priority.

Furthermore, prevention does not always produce quick or visible results easily quantified in a quality measure. A blood pressure check today may prevent a heart attack years from now. A cancer screening may save a life when treatment is provided early. Many preventive efforts lower risk over time, long before symptoms appear. Prevention delivers impactful long-term health benefits. It reduces physical and mental health suffering, lowers health care costs, and helps people live healthier lives. 

CMS measures shine a light on the health care issues that matter most, ensuring hospitals and providers focus on improving care in ways that matter to patients – including making prevention a routine part of care. That’s why measurement is so essential, and why CMS and PQM play a vital role in strengthening health care for everyone.

How CMS Shapes Prevention Through Measurement

Through its quality measurement programs, CMS uses measures to signal national priorities, including prevention. These measures help turn health goals into efficient measurable expectations for everyday care.

Measuring prevention effectively and efficiently is not simple. When prevention is tracked only as a one-time action, it can create a false sense of success. A blood pressure screening may “count” as prevention, but it does not protect health unless blood pressure stays under control over time. Cancer screenings matter, but without timely follow-up on abnormal results, they cannot prevent harm.

Stronger prevention measures focus on what actually improves health – timely follow-up, continuity of care, and sustained outcomes. They shift the question from simply, “Was this completed?” to the more meaningful, “Did it make a difference?”

Measurement can also highlight gaps in care. Overall vaccination rates may look strong, but when data are broken down by neighborhood, income, or insurance status, gaps often appear. Without measuring these differences, communities most in need of prevention can be overlooked.

The Role of the Partnership for Quality Measurement (PQM)

Designing good measures requires more than technical expertise – it requires real-world perspective and lived experience. That is why the PQM plays such an important role in getting it right.

PQM brings together patients, caregivers, clinicians, researchers, and community voices to review and improve the quality measures used by CMS. Its role is to ask practical questions: 

• Do these measures reflect what matters to patients? 
• Are they realistic to use? 
• Do they support better care – or simply create more paperwork?

CMS and PQM help ensure that measures support meaningful prevention rather than check-the-box activities, and that access, burden, and real-world care are considered from the start.

Why the Right Measures Matter 

Poorly designed prevention measures can undermine care. When systems focus too much on documentation, clinicians spend more time on paperwork and less time with patients. When access is measured without impact, prevention may look successful on paper but fall short in real outcomes. Similarly, reporting on fairness and access can fall short when gaps are identified but no support exists to address them. 

Bottom line: measurement should guide learning and improvement, not simply point out problems. These challenges in prevention efforts remind us that how we measure matters just as much as what we measure. The collective efforts of CMS and PQM help prevention become proactive, fair, and responsive to community needs. 

The Takeaway

Prevention is not a single visit or a single test. It is a long-term commitment to people and communities. When health goals are paired with efficient and effective measurement, prevention becomes part of everyday care, not just a policy aspiration. Prevention works best when we measure what truly improves health, not just what is easiest to count.

You don’t have to be a policy expert to help shape prevention. Patients, caregivers, clinicians, and community members can support this work by engaging with PQM – by sharing lived experience, providing public input, or participating in measure review – to help ensure prevention measures reflect real-world care.

Brenna Rabel is the Healthcare Quality Measurement Science Leader at Battelle. Edessa Jobli is a Senior Project Research Associate at IHI.

Photo by Freepik

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