Washington, D.C. – Today, Americans spend twice as much on health care as citizens of other developed nations, yet we have shorter life expectancies and higher rates of infant mortality and diabetes. These startling statistics have led to a consensus among experts that innovative prevention strategies will improve health outcomes and lower health care costs. A new report released today by the Bipartisan Policy Center (BPC) recommends ways to accelerate investment in prevention strategies within the rapidly changing health care delivery system landscape.
“Galvanizing a national effort to prevent chronic disease is imperative,” said Prevention Task Force Senior Advisor Bill Frist, M.D., “These recommendations will help develop new financing mechanisms and integrated programs and services that will shift America’s health care system toward disease prevention and wellness.”
A Prescription for Improving Health and Health Care in America was developed over the past year by BPC’s Prevention Task Force, a group of experts from across the health, public health and budget sectors. The task force strongly believes a more integrated and prevention-centered approach to health and health care will go a long way toward advancing the goals of better health and lower health care spending.
However, the report points out two main obstacles that prevent the U.S. from implementing an integrated, prevention-centered approach: 1) Fee-for-service models do not reward physicians for counseling patients on preventive changes to improve health, and 2) Health care providers have historically operated with little or no connection to non-medical, community-based organizations.
“We must find ways to refocus America’s health care system on improving coordination, bridging the gap between clinic and community, finding effective ways to evaluate prevention interventions and measuring impacts so we are working to prevent illness rather than just treating it after it happens,” said Prevention Task Force Senior Advisor Alice M. Rivlin.
BPC’s Prevention Task Force proposes a two-part framework to tackle these challenges:
Build the evidence base on the value of prevention by capturing the best available data on effective interventions and developing the appropriate metrics and economic analysis for evaluating progress.
The task force recommends that the federal government, including the Centers for Disease Control and Prevention, National Institutes of Health, Centers for Medicare and Medicaid Services (CMS), and Congress, as well as other public and private stakeholders, support research and programs that include robust economic analysis to promote prevention strategies that are known to improve health and cut costs.
”Developing sustainable funding models is crucial if we are to bring successful community-based prevention strategies to scale as a prominent and permanent feature of the larger health delivery landscape,” said BPC Prevention Task Force Member Jeffrey Levi, Ph.D., executive director of Trust for America’s Health.
Make prevention a key part of health care delivery system reform by shifting from a volume to value-based care and forging new partnerships among community organizations and traditional health care providers.
The passing of the Affordable Care Act provides opportunities to shift towards more quality- or value- based incentive structures. The task force recommends that CMS integrate population health care quality measures into the next iteration of accountable care organizations and invest in developing and evaluating demonstrations of an accountable health community model. Additionally, communities, public health officials, and hospitals should collectively explore ways to improve community health needs assessments and collaborate on common goals in their communities.
“Our current health care system has few structural or financial mechanisms to connect health care providers to the broader community beyond the clinic walls,” said BPC Prevention Task Force Member William Dietz, M.D., Ph.D., director of the Sumner M. Redstone Global Center for Prevention and Wellness at the Milken Institute School of Public Health at the George Washington University. “Building supportive community systems and integrating them with clinical interventions is essential, because where people live, work, learn, and play has a greater influence on Americans’ health than what goes on in the doctor’s office.”