FROM THE FOUNDATION

Redefining the Safety Net

Should California establish a Basic Health Program for certain low-income residents? CHCF's Marian Mulkey captures a recent policy conversation in a Health Affairs blog.

Accountable Care in Action

A new post on the Health Affairs blog details how CalPERS kept costs down in Sacramento through a "virtual" ACO with insurers and providers.

Career Opportunity: Senior Program Officer

This position will play a major role in furthering the goals and objectives of the foundation's Better Chronic Disease Care program.

Special Reports

Monday, April 19, 2010

Prevention, Wellness Provisions of Health Care Reform Law Could Have Big Long-Term Impact

Health advocates say a shift toward emphasizing prevention and wellness could be a game-changer in our health care system.

Some estimates say roughly half the conditions we treat in our health care system are avoidable. Several prevention initiatives in the new health care reform law seek to change that.

In a California Healthline Special Report by Kelly Wilkinson, experts discuss how the health care reform law will boost preventive health care.

The Special Report includes comments from:

  • John Seffrin, CEO of the American Cancer Society;
  • Steve Wojcik, vice president of public policy for the National Business Group on Health; and
  • Daniel Zingale, vice president of Healthy California at the California Endowment.

The health reform law significantly expands preventive screenings for Medicare beneficiaries. Meanwhile, health insurers will have to fully cover recommended screenings, preventive care and vaccines. It also increases the reimbursement rate for doctors who offer preventive services to their patients (Wilkinson, California Healthline, 4/19).

Running Time: 5:00

Reader Comments:
  • 5
  • 05/07/2010
  • Susan Kidder

I was going to respond to this ... but 1,000 characters gives you only enough space for soundbites. The Devil's in the Details on this. If, for example, we define "prevention of cardio-vascular disease" as starting to give statin drugs to people who "might be at risk of developing disease" ... then there's no important Change happening. If, on the other hand, the prevention interventions fall more in line with diet, exercise, and the ability of emerging fields of medicine - like functional medicine - to take on Metabolic syndrome and reset human metabolism into healthy balance ... before the individual in question procedes into full-blown diabetes or cardio-vascular disease ... now we're beginning to talk about a serious shift in our medical model. At the moment, we have a healthcare system that is neither about health - nor care.

  • 4
  • 05/04/2010
  • Gary Levin

COuldn't agree more. Let's have an on-going very long term longitudinal RCT on the major diseases to see if secondary prevention really works. The DM companies were "showing" results in one year (one of the HMO's showed earnings in the 10's of millions which helped their stock, reduced reserves, etc). We all certainly hope it works; I just don't see the data supporting budgetary savings despite the logic behind it. Without the data, I'm not sure I want my tax dollars spent on false hope.

  • 3
  • 04/27/2010
  • Stephen Hansen

Mr. Levin suggests that studies of interventions which were not well marketed and had poor carrots and sticks have relevance to this discussion. Moreover, the timeline for outcomes analysis on preventive measures was too short. (CHBRP has had a similar flaw in that regard.)
Thus the prior comments regarding grassroots, business, and institutional incentivised buy-in are especially important. Then let's have another study--in a few years.

  • 2
  • 04/25/2010
  • Gary Levin

Unfortunately, this is mostly hype. Take a look at the THREE independent medicare randomized controlled trials looking at disease management programs (chronic disease management, secondary prevention) and ALL of them failed to show cost savings or QI. Logic is not equal to fact.

  • 1
  • 04/22/2010
  • Stephen Hansen

This needs to be repeatedly aired in every chamber of commerce,union,nonprofit, church, medical organization, ins.plan, government health or welfare entity, etc. The essentials must be posted on provider's walls in plain view, and ins. plans must ask insureds to affirm the receipt/acceptance of the information in order to qualify for a preferred rate incentive. Is this information explained for 4th-grade-level readership on the HHS site? Thanks.



Readers are invited to send feedback to: chl@chcf.org