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Congressional Budget Office
House Budget Committee Roundtable
June 16, 2020
Phillip Swagel
Director
How CBO Analyzes Appro...
1
CBO
Expanded Use of Many Preventive Medical Services
Has Improved Health and Increased Health Care Costs
The use of prev...
2
CBO
Savings come from only a subset of people who receive the services—from
preventing diseases or identifying and treat...
3
CBO
The effects on the federal budget are often smaller than the effects on total health
care spending because the feder...
4
CBO
CBO estimated that covering tobacco cessation services for pregnant women
under Medicaid would reduce federal spendi...
5
CBO
A vaccine for the coronavirus has not yet been approved and made widely
available.
CBO anticipates that if and when ...
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How CBO Analyzes Approaches to Improve Health Through Disease Prevention Slide 1 How CBO Analyzes Approaches to Improve Health Through Disease Prevention Slide 2 How CBO Analyzes Approaches to Improve Health Through Disease Prevention Slide 3 How CBO Analyzes Approaches to Improve Health Through Disease Prevention Slide 4 How CBO Analyzes Approaches to Improve Health Through Disease Prevention Slide 5 How CBO Analyzes Approaches to Improve Health Through Disease Prevention Slide 6
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How CBO Analyzes Approaches to Improve Health Through Disease Prevention

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Preventive medical services encompass a wide range of interventions, including vaccinations that prevent diseases from occurring and screening tests designed to detect the presence of a disease before symptoms appear. Delivering preventive medical services results in costs for each person using the service. Vaccinations may cause some of those people to avoid the targeted disease, and screenings may allow some people to receive treatment earlier. Those people generally benefit from preventive medical services, but the net result can be decreases or increases in overall health care spending.

In this presentation, CBO’s Director provides an overview of the agency’s methods for estimating the budgetary effects of proposals to expand the use of preventive medical services.

How CBO Analyzes Approaches to Improve Health Through Disease Prevention

  1. 1. Congressional Budget Office House Budget Committee Roundtable June 16, 2020 Phillip Swagel Director How CBO Analyzes Approaches to Improve Health Through Disease Prevention
  2. 2. 1 CBO Expanded Use of Many Preventive Medical Services Has Improved Health and Increased Health Care Costs The use of preventive medical services can, and often does, improve people’s health. A comprehensive review of the research literature conducted in 2008 found that most preventive medical services improved health but that about 80 percent of them led to higher health care spending overall. A 2014 study by the Government Accountability Office supported the findings of the 2008 review.
  3. 3. 2 CBO Savings come from only a subset of people who receive the services—from preventing diseases or identifying and treating them early on. Even when the price of a particular service is low, costs can accumulate when many people receive it. Services can have unintended costs (adverse reactions to vaccinations and false positives from screenings, for example). Services may increase patient longevity, resulting in people living longer and potentially incurring treatment costs for other medical conditions. Preventive Medical Services Can Increase or Decrease Health Care Spending
  4. 4. 3 CBO The effects on the federal budget are often smaller than the effects on total health care spending because the federal government does not pay for all health care. Some people may already be receiving the service; for them, additional federal support might shift costs to the government without improving health. Savings may not fully emerge within the 10-year budget period. Improved patient longevity can increase federal outlays. Effects on the Federal Budget May Differ From Effects on Overall Health Care Spending
  5. 5. 4 CBO CBO estimated that covering tobacco cessation services for pregnant women under Medicaid would reduce federal spending for that program. CBO estimated that expanding Medicare’s benefit package to waive cost sharing for the “Welcome to Medicare” visit and include a new annual wellness visit with no cost sharing would increase federal spending for that program. CBO Analyzes the Effects of Legislative Proposals to Expand Preventive Medical Services on a Case-by-Case Basis
  6. 6. 5 CBO A vaccine for the coronavirus has not yet been approved and made widely available. CBO anticipates that if and when that happens, the effects on the federal budget could be substantial and would depend on many factors. Legislation related to a vaccine for the coronavirus differs from proposals involving most other preventive medical services in that it could have major macroeconomic effects, such as a faster rebound of economic activity and increases in tax revenues. The size of such effects would depend on many factors. By long-standing convention, such effects generally are not reflected in CBO’s cost estimates. The Effects of a Coronavirus Vaccine on the Federal Budget Could Be Substantial But Are Very Uncertain
  • AndrewBroderick

    Jun. 16, 2020

Preventive medical services encompass a wide range of interventions, including vaccinations that prevent diseases from occurring and screening tests designed to detect the presence of a disease before symptoms appear. Delivering preventive medical services results in costs for each person using the service. Vaccinations may cause some of those people to avoid the targeted disease, and screenings may allow some people to receive treatment earlier. Those people generally benefit from preventive medical services, but the net result can be decreases or increases in overall health care spending. In this presentation, CBO’s Director provides an overview of the agency’s methods for estimating the budgetary effects of proposals to expand the use of preventive medical services.

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