Focusing on Preventive Care Could Generate Savings, Report Finds

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The U.S. could save billions of dollars annually in health care costs by coordinating public health resources at the federal, state and local levels to focus on preventive health care, according to a report released Tuesday by Trust for America's Health, Reuters reports.

Report Details

The report outlines a plan to "move from sick care to health care" by directing more resources to preventing chronic illnesses, rather than treating them (Begley, Reuters, 1/29).

At the federal level, the report criticized HHS' recent attempts to coordinate efforts between its different agencies as being too slow. It said that HHS agencies often work independently on different health problems even though some have "overlapping functions and serve overlapping populations." Specifically, the report noted that CDC programs often are "siloed and based on diseases and conditions," rather than offering integrated and focused prevention strategies. 

The report also suggested that the federal government increase public health funding and streamline its technology, which supports more than 300 health surveillance systems and networks. 

At the local level, the report urged public health departments to take more responsibility for the public's health and strengthen their role as the health leaders in their community. 

TFAH Executive Director Jeffrey Levi in a statement said, "Prevention delivers real value as a cost-effective way to keep Americans healthy and improve their quality of life" (Barr, Modern Healthcare, 1/29).

Health Care Economists Refute Savings From Preventive Services

Health care economists have refuted the idea that investing more in preventive services would lower costs, Reuters reports. Health care economists have found that many preventive care services are costly and offer little or no benefit to individuals, such as annual physicals for health adults.

Ateev Mehrota, a health care analyst at RAND, noted that about one-third of U.S. adults get an annual physical for a total cost of about $8 billion annually.

Further, preventive care nets few savings because many people need to be screened to prevent a single, costly illness. For example, a study published in the journal Health Affairs in 2010 found that if 90% of U.S. residents used proven preventive services, it would reduce U.S. health care spending by just 0.2%.

"[P]revention itself costs money, and some preventive measures can be very expensive, especially if you give them to a lot of people who won't benefit," Peter Neumann, a health policy expert and professor at Tufts University School of Medicine, said. 

Economists have noted that some low-cost preventive measures are beneficial to public health and produce health savings, such as adults taking aspirin to ward off a heart attack or stroke, childhood immunizations and screening for high blood pressure and some cancers, including colorectal and breast.

However, in order for preventive services to succeed in reducing health costs, economists say preventive care should be targeted at high-risk individuals and in some cases should be addressed in settings outside of a physician's office (Reuters, 1/29).

Jacob Kuriyan
As Bill Gates observed in an opinion column in the Wall Street Journal Jan. 25., the key to performance and results is "measurement". Without it there is a cacophony of conflicting opinions - "yes, prevention saves money!", "How could it when you are spending more for care delivery?' etc. etc. When it comes to chronic disease prevention we have no way of measuring performance at this time - short of waiting for a decade to look for reductions in deaths, heart attacks etc. Even the famous article by Don Berwick et. all on Triple Aim published in Health Affairs several years ago points out the necessity of measuring improvements in a population's health to determine if a program is successful - but it does not tell you how to do it.

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