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Two New Issue Briefs -- Combating Chronic Health Problems with Public Health Initiatives & Oral Health Challenges and the Health Law


Monday, October 29, 2012

Two new issue briefs from the Alliance for Health Reform examine the ability of public health initiatives to deal with costly chronic health conditions and the persistence of barriers to oral health care. The nonpartisan Alliance produced the briefs with support from the Robert Wood Johnson Foundation.

The first brief, Public Health Prevention Efforts: Saving Lives, Saving Money?, available here, examines chronic conditions as a huge driver of health care costs, and the potential help of public health initiatives. Obesity, for example, is closely associated with several chronic conditions, and diabetes and other chronic conditions can often be prevented or delayed by addressing health-related behaviors such as smoking, physical inactivity and poor diet.

A recent Institute of Medicine report calls for the doubling of funding for public health programs—including prevention services. But there are questions about whether preventive services improve health outcomes, whether public agencies recoup their investments, and whether expenditures can lower the deficit and contribute to economic growth.

The second brief, Oral Health and the Affordable Care Act: Only Part Way to the Finish Line, available here, identifies provisions in the Patient Protection and Affordable Care Act that expanded dental coverage, primarily for kids, and called for education. Some provisions in the law have not been funded. Many adults currently lack dental coverage, and minorities and poor people are at the highest risk for disease. Some states are considering legislative proposals to train and license less expensive mid-level practitioners – somewhere between dentists and hygienists – to be able to do more. Dentists believe these proposals will lower the current standard of care and compromise patient safety.

The briefs, available here, draw from information presented at two recent Alliance congressional briefings. Chronic Disease Prevention: Saving Lives, Saving Money took place on July 13, 2012. A webcast of the briefing is available here. Oral Health: Putting Teeth into the Health Care System took place August 17, 2012. A webcast of that briefing is available here.

Contact: Marilyn Werber Serafini 202/789-2300

 


Uwe Reinhardt Questions Bundled Payment Savings Prospects


Video (2:58)

A new Alliance for Health Reform video features Princeton’s Uwe Reinhardt questioning whether bundling payments for medical services might actually lead to higher – not lower – costs.

"The ACO's, the accountable care organizations, could create local monopolies that could dictate to you what that bundled price would be, and some of us fear that bundled prices might be even more than what the fee-for-service for that bundle would be today. … You really should align all the payers and say, 'Let us jointly negotiate with the ACOs what those bundles should be so that they cannot divide and rule and sort of make us on the buy side weak.'"

FULL TRANSCRIPT

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Sister Carol Keehan on Health Law Enrollment Challenges this Year


Video 3:00

A new Alliance for Health Reform video features Sister Carol Keehan of the Catholic Health Association of the United States addressing the challenges of quickly enrolling millions of Americans for health insurance this fall. Open season begins October 1 of this year, yet she says that up to 85 percent of those who will be newly eligible for Medicaid or for subsidies to buy private insurance in state-based exchanges don't know it.  FULL TRANSCRIPT

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Jonathan Blum on CMS Efforts to Keep Medicare Spending Growth Down


Video (2:54)

Jonathan Blum, acting principal deputy administrator and director of the Center for Medicare at the Centers for Medicare and Medicaid Services (CMS), addresses the slower growth of Medicare spending over the last few years, and what his agency is doing to try and continue the trend. “There are promising signs that this strategy to change the payment system, to change the payment models, to focus on waste and abuse, is paying off," he said. "We are taking a whole new approach to addressing fraud in the program. Much more data resources, much more on the ground reaction. We have seen dramatic spending declines in areas of spending, such as home health and durable medical supplies that historically fueled lots of the fraud.”  FULL TRANSCRIPT

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Two Former Medicare Administrators Discuss How to Save the Program


A new Alliance for Health Reform video features two former Medicare administrators -- Gail Wilensky and Bruce Vladeck -- on their ideas about how to save the program.

Ms. Wilensky, who ran Medicare in a Republican administration, argued for increasing the eligibility age of Medicare for future retirees, while still making the program available at age 65 for those who are disabled.

Watch at http://www.youtube.com/watch?v=GQjsfam9-w0

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Douglas Holtz-Eakin: Health Care Spending Lull Only Temporary


Video (3:11)

A new Alliance for Health Reform video features Douglas Holtz-Eakin of the American Action Forum, and a former director of the Congressional Budget Office, arguing that recent slower spending growth in health care won’t continue.

"We also saw a slowdown in the mid-90s, and we all declared victory and it came right back. I think next year we’ll see a noticeable uptick. There will be lots of new people entering the insurance markets because of the exchanges and the subsidies that come along with them, and those subsidies are very generous. … These are an invitation for people to get coverage and to buy more health care. I think that’ll place a lot of pressure on spending."

FULL TRANSCRIPT

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Marketplace Enrollment Helpers Toolkit


Beginning October 1, insurance marketplaces open for enrollment, and millions of people will be eligible to purchase plans. To guide them in the application process, the federal government has invested in programs to train community organizations and hired staff.

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The Employer Mandate of the Patient Protection and Affordable Care Act


The Toolkit, available here, details the ACA’s employer requirements and penalty. It also includes information about the delay in the mandate to 2015, and analysis about its impact on employer-based coverage.

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Toolkit: Training the Workforce for a Changing Health System


A new Alliance for Health Reform toolkit addresses concerns about whether newly-trained physicians are adequately prepared for today's evolving health care delivery system. Does training adequately emphasize care coordination, team-based care, costs of care, health information technology, cultural competence and quality improvement? Does it encourage students to practice in a primary care setting?

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Toolkit: Emergency Preparedness in the U.S.: The Ebola Threat


Is the U.S. prepared for a potential virulent pandemic? This new Alliance toolkit examines public health infrastructure, funding and policy levers that deal with these kinds of health crises in America.

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