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Unfunded Programs and Implementation
Monday, November 8, 2010
With Republicans holding the gavel in the House, it seems it will be nearly impossible to get any additional funding for programs authorized under the health care law. Many of the authorized, but not appropriated, programs focus on work force and prevention efforts. In addition, there are two unfunded programs that may be essential to the long-term success of the law, including a Medicaid global payment demonstration and a program requiring the Office of Personnel Management to contract with health insurers to offer "at least two multi-state health plans" in each states' insurance exchange.
What impact will these unfunded programs have on the implementation of the law? Will it be possible for Democrats to get any additional money?
November 11, 2010 10:48 AM
Prevention and Wellness Programs Are Key
By Kenneth E. Thorpe
Robert W. Woodruff Professor and Chair, Department of Health Policy and Management, Rollins School of Public Health Emory University
The prevention and wellness initiatives in PPACA are critical to the law’s success, in terms of reducing health care spending and improving health outcomes. There is an indisputable body of research that shows when prevention is done right (i.e., evidence-based programs that target at-risk populations), the savings—in lives and dollars—is great. A recent Health Affairs article shows that increasing the use of 20 proven clinical preventive services (including tobacco cessation screening, alcohol abuse screening, and daily aspirin use) from current levels to 90 percent in 2006 could avert the loss of more than two million life-years annually and result in total savings of $3.7 billion, or 0.2 percent of U.S. personal health care spending.
Prevention and wellness initiatives in PPACA, while requiring an initial investment, pay for themselves over a 10-year window, and many in as few as 2-3 years. Workplace and community wellness programs supported in the bill are extremely e...
The prevention and wellness initiatives in PPACA are critical to the law’s success, in terms of reducing health care spending and improving health outcomes. There is an indisputable body of research that shows when prevention is done right (i.e., evidence-based programs that target at-risk populations), the savings—in lives and dollars—is great. A recent Health Affairs article shows that increasing the use of 20 proven clinical preventive services (including tobacco cessation screening, alcohol abuse screening, and daily aspirin use) from current levels to 90 percent in 2006 could avert the loss of more than two million life-years annually and result in total savings of $3.7 billion, or 0.2 percent of U.S. personal health care spending.
Prevention and wellness initiatives in PPACA, while requiring an initial investment, pay for themselves over a 10-year window, and many in as few as 2-3 years. Workplace and community wellness programs supported in the bill are extremely effective and cost efficient health interventions for many of the chronic conditions that drive up health care costs, such as obesity, heart disease and diabetes. For example, structured lifestyle interventions in the YMCA’s DPP have shown a 58% reduction in the incidence of diabetes, with cost savings within 2 years, if the direct costs of the intervention can be reduced to $250 - $300 per year.
While many of these critical prevention reforms await appropriation, we risk losing significant cost saving potential in our current health care system and are unable to fix our costly and fragmented delivery system that PPACA set out to fix.
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