Until recently, the use of such services has been low among older adults because Medicare coverage has not been extended to many preventive services (3). Medicare coverage now includes four clinical preventive services: a single lifetime pneumococcal polysaccharide vaccination (vaccine plus any required revaccination and administration) (since 1981); annual influenza vaccination (vaccine and administration) (since 1993); and for women, biennial mammography screening (since 1991) and Papanicolaou smear screening every 36 months (since 1990) (4,5).

To assess current state-specific levels of use of these services among Medicare beneficiaries, CDC and the Health Care Financing Administration (HCFA) analyzed data from the 1995 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the findings of this analysis, which indicate that, despite Medicare coverage of these preventive services, many U.S. adults aged greater than or equal to 65 years did not receive such services in 1995, and state-specific use of these services varied substantially.

NCHS has developed a record linkage program designed to maximize the scientific value of the Center’s population-based surveys. NCHS is currently linking various NCHS surveys with Medicare enrollment and claims records collected from the Centers for Medicare and Medicaid Services (CMS).

Linkage of the NCHS survey participants with the CMS Medicare data provides the opportunity to study changes in health status, health care utilization and expenditures in the elderly and disabled U.S. population.