U.S. Can Do More To Boost Preventive Care Efforts, Paper Argues

The U.S. can improve preventive care by boosting its evidence base on the topic and by integrating prevention efforts into health care delivery system reforms, according to a Bipartisan Policy Center paper released Thursday, Modern Healthcare reports (Robeznieks [1], Modern Healthcare, 5/28).

The paper recommended that research efforts make greater use of economic analysis in health care decision-making (Young, CQ HealthBeat, 5/28). They advised that CDC and NIH-funded research implement economic analyses into their studies. Further, the paper called for public health journals to encourage economic analyses in the prevention studies they publish.

The paper also noted that preventive health measures could be embedded in overarching delivery reform efforts.

It recommended that the Center for Medicare and Medicaid Innovation invest in an accountable health community that would establish population-health framework in addition to the existing delivery setup.

The paper also suggested that CMS create mechanisms to address "wrong pocket" issues, in which providers benefit from long-term savings created by another provider's investment in prevention.  

In addition, the paper suggested that physicians receive reimbursements for counseling patients about how to improve their health.

Overall, the authors noted that CMS will have to incentivize health promotion over disease treatment and create financial incentives and policy changes for prevention-focused reforms to work in the long term.

Savings

The paper did not estimate the savings its suggestions would yield. However, it gave examples of savings from prevention-focused efforts already underway, such as a Minnesota accountable care organization that has helped bring down per-patient costs by 30% and a YMCA-American Medical Association partnership program that is projected to save $1.3 billion over a decade (Robeznieks [1], Modern Healthcare, 5/28).

Reaction

American Public Health Association Executive Director Georges Benjamin called the suggestions "right on the mark." He added that the paper should spur conversations about the amount of time it takes to see a return on preventive and public health measures. In addition, he supported the proposal's call for more economic analyses. He said such measures would end "foolish economic arguments" about how living longer results in higher health care costs (Robzenieks [2], Modern Healthcare, 5/28).