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National Prevention, Health Promotion and Public Health Council issues first report

Posted on June 30, 2010 | No Comments

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Key Developments

The National Prevention, Health Promotion, and Public Health Council, which was created by the health reform law, has submitted its first report to Congress.

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According to a survey released by the Kaiser Family Foundation (KFF), preventive health services are well-covered by state Medicaid programs, despite the fact that these services are optional for nonelderly adult Medicaid enrollees. The KFF study reported that 44 states covered a least 30 out of 42 optional preventive services, with 25 states covering 40 or more of the optional preventive services. These optional services include 1) screening for cancer and sexually transmitted infections, 2) services related to chronic conditions such as diabetes, and 3) immunizations. There was significant variation with regard to cost-sharing requirements for these services. Of the 13 states that covered all of the 42 preventive services, only five of these states covered these services without cost sharing. The Affordable Care Act (ACA) makes available financial incentives for covering these preventive services. State Medicaid programs, for example, may receive an increased federal Medicaid matching rate if they cover immunizations recommended by the Centers for Disease Control and Prevention and certain preventive services recommended by the U.S. Preventive Services Task Force.
The United States spends twice what most other industrialized nations spend on health care, yet ranks 24th out of 30 such nations in terms of life expectancy. America spends 3 percent of health care dollars on preventing diseases (as opposed to treating them), when 75 percent of costs are associated with preventable conditions. To adequately meet prevention needs, and to control unsustainable growth in health care costs, a 2012 Institute of Medicine (IOM) report recommended that the U.S. increase federal funding for public health and prevention by $12 billion annually. According to a report recently published by the American Public Health Association, a key first step toward meeting this need is the Prevention and Public Health Fund, a mandatory fund for prevention and public health programs created by the Affordable Care Act (ACA). The purpose of the Fund is to provide a stable and increased investment in activities that will enable communities to stay healthy in the first place, and it was designed to gradually build from $500 million in FY 2010 to $2 billion per year by FY 2015. Despite a recent legislative reduction of $6.25 billion over nine years to help postpone a cut in Medicare physician payments, and some use of the Fund to replace existing appropriations, the Fund still represents a crucial investment in the health of communities and in the nation’s long term fiscal health.
In the United States, the Affordable Care Act (ACA) raised the maximum allowed wellness incentives, which are thought to improve health and reduce costs. Public insurers in Germany operate many such programs. Participation in these programs nearly doubled between 2004 and 2008, reaching one-quarter of the publicly insured population. An evaluation of one large wellness program there found that it reduced costs. However, population-level survey data also suggest that individuals with low incomes or poor health are less likely to enroll. Under the ACA in the United States, the increase in allowed wellness incentives could lead to wide differences in insurance premiums between users and nonusers of programs, and may risk reintroducing a form of medical underwriting. The German case study confirms the cost-saving potential of programs, but also suggests that they should be evaluated rigorously to ensure they do not disadvantage those with health problems or low incomes. A report published by The Commonwealth Fund reviews and provides insight on this issue.
The National Association of County and City Health Officials (NACCHO) surveyed local health departments (LHDs) nationwide to measure the impact of the economic recession on LHDs’ budgets, staff, and programs. Results of the study, the seventh in a series, show that many LHDs continue to struggle to serve their communities in the face of ongoing fiscal constraints. In 2011, 57 percent of LHDs reduced or eliminated services...
The Urban Institute recently released a report documenting the potential savings available in prevention of avoidable chronic illness. The high and rising prevalence of chronic disease represents a substantial burden on the medical care system and a major cost for society, leaving aside its toll on individuals. The burden presents as rising rates of obesity, increased prevalence of diabetes, greater incidence of disability, and the rising cost of medical care and other disease-related costs. The Congressional Budget Office (CBO) reports that medical spending on obese adults is 38 percent higher than on their normal-weight counterparts. The cost of cardiovascular disease in medical treatment and lost productivity has been estimated at $400 billion per year, of which about one-quarter comes from lost productivity. The California Public Employees' Retirement System (CalPERS) health program covers...
The Commonwealth Fund recently published a paper in Medscape Public Health regarding preventive health services under the Affordable Care Act (ACA). The law has already extended coverage to dependents through age 26. By 2014, Medicaid will expand to cover most low-income adults and the exchanges will extend insurance to many small business and individuals. This eminent expansion of health insurance coverage will greatly increase in the use of preventive services in the United States. ACA provisions also eliminate cost sharing associated with the provision of preventive services, which will also likely impact use. Finally, the movement toward medical homes will also augment the use of preventive services. The paper discusses these relationships in the context of delivery system reforms.
Although the United States spends more than any other country on health care, the country continues to lag behind the rest of the industrialized world in life expectancy and child morality. In a report commissioned by the Robert Wood Johnson Foundation and authored by Institute of Medicine (IOM), the authors argue that this discrepancy is attributable to the underfunded public health system. The report calls for...
The Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) updated estimates for 15 selected health measures based on data from the 2011 National Health Interview Survey (NHIS) and presented estimates from 1997 through 2010 for comparison in an early release of data from the National Health Interview Survey. The 15 measures included in the present report are...
The U.S. Department of Health and Human Services (HHS) released today the National Prevention Council Action Plan, which aims to increase the number of Americans who are healthy at every stage of life. The plan is the next step in federal implementation of the National Prevention Strategy, a comprehensive plan to tackle such issues as obesity, tobacco use, health disparities and chronic disease. The Action Plan complements prevention and wellness efforts already underway by the federal government, states, tribal and local governments, health care systems, businesses, communities, nonprofit organizations, and others. The National Prevention Council, established by the Affordable Care Act (ACA) released the National Prevention Strategy last year. The council’s mission is to help move the nation’s health care focus from one based on sickness and disease to one on prevention and wellness. The action plan includes commitments from...