Written by Adele Allison, National Director of Government Affairs, SuccessEHS.
The shape of the U.S. health care industry is changing every day, and this presentation sheds light on some interesting statistics including Primary Care Providers, The American Patient, Health Care and the U.S. Economy and more.
Today it’s critical for providers to devote time to patient education; inform patients about their conditions and how to prevent, treat, and manage them. Proper management of chronic conditions extends well beyond episodic and infrequent visits to a provider’s office. This population health white paper discusses why patients must become responsible for their day-to-day disease management. Patients will frequently be required to self-monitor their health indicators, observe symptoms, and note behavior, but they must also adhere to complex medication regimens
Reactive Vs. Preventative Healthcare for Seniorsrachelgmoore
Exorbitant costs are breaking the back of the nation's healthcare system, and seniors are shouldering significantly more than their fair share of the burden. A large portion of these costs are due to a reactive healthcare model - one that only addresses problems after they arise.
In this infographic, learn about how a shift towards a preventative care model for seniors can decrease healthcare costs, improve quality of care, and quality of life, as well as some of the technologies senior living and care providers can use to promote preventative care and their organizations.
Get the high resolution version here: http://hubs.ly/y0Yj4b0
Written by Adele Allison, National Director of Government Affairs, SuccessEHS.
The shape of the U.S. health care industry is changing every day, and this presentation sheds light on some interesting statistics including Primary Care Providers, The American Patient, Health Care and the U.S. Economy and more.
Today it’s critical for providers to devote time to patient education; inform patients about their conditions and how to prevent, treat, and manage them. Proper management of chronic conditions extends well beyond episodic and infrequent visits to a provider’s office. This population health white paper discusses why patients must become responsible for their day-to-day disease management. Patients will frequently be required to self-monitor their health indicators, observe symptoms, and note behavior, but they must also adhere to complex medication regimens
Reactive Vs. Preventative Healthcare for Seniorsrachelgmoore
Exorbitant costs are breaking the back of the nation's healthcare system, and seniors are shouldering significantly more than their fair share of the burden. A large portion of these costs are due to a reactive healthcare model - one that only addresses problems after they arise.
In this infographic, learn about how a shift towards a preventative care model for seniors can decrease healthcare costs, improve quality of care, and quality of life, as well as some of the technologies senior living and care providers can use to promote preventative care and their organizations.
Get the high resolution version here: http://hubs.ly/y0Yj4b0
Bibliographie sur la couverture sanitaire universelle - AfHEAHFG Project
On October 28, Health Systems Global (HSG)’s Translating Evidence into Action Working Group hosted a webinar on a regional initiative to empower public and private leaders in Francophone Africa with evidence and research related to universal health coverage (UHC). In response to calls for UHC reforms in the region, the African Health Economics and Policy Association (AfHEA) has trained over 45 policymakers and other stakeholders from 16 countries across Francophone Africa to address their urgent need for relevant evidence and knowledge to advance their country’s progress towards UHC. Training participants were self- or employer- financed, and came from Ministries of Health, quasi-governmental agencies (social security agencies, health insurance), or were young African researchers, analysts, and activists in civil society.
The webinar focused on how AfHEA made the wealth of evidence on financing and structuring UHC in English, accessible in French (What did policy makers need to make UHC policy and how did AfHEA get it to them successfully?) and how the training participants continue to support each other in using evidence to inform policy (Where do policymakers go for evidence or technical support and what is most useful to them?). The hour-long webinar—held in French with a separate line for simultaneous English translation—saw over 50 participants and featured four speakers.
Speakers:
Pascal Ndiaye, Health Finance and Policy Specialist, AfHEA (Moderator)
Miloud Kaddar, Senior Health Economist, World Health Organization (Panelist)
Marie Nome Essoh Lattroh, Technical Adviser, Ministry of Economy and Finance, Senegal (Panelist)
Hugues B.M. Tchibozo, Deputy Director General, National Health Insurance Agency, Ministry of Health, Benin (Panelist)
The panel included training participants (Ms. Lattroh and Mr. Tchibozo), an instructor (Mr. Kaddar), and an organizer (Mr. Ndiaye). The diverse experiences provided for a rich panel and discussion.
Major takeaways from the webinar:
The increased global focus on UHC represents an opportunity to advance policies and strategies for extending health care access to vulnerable populations across Africa.
UHC should be a medium to long term goal requiring a health systems approach and sustained engagement by all actors and stakeholders.
There is no single source of funding for UHC.
Resolving shortages and unequal distribution of the health workforce in Africa is essential for achieving UHC.
While the term “universal” signals that the entire population will be “covered,” an unanswered question is: covered with what? What benefits or interventions represent “coverage”?
The importance and diversity of the informal sector requires special attention. Policies must be based on context-specific evidence of what works.
A Comparative Analysis Of The UK And US Health Care Systemsabbiemc
- Published a comparative review of health systems of the National Health Service in the United Kingdom and the varying approaches to health systems in the United States
- Developed research question, conducted interviews, utilized PubMed and similar research database systems, performed literature review, and prepared and submitted for publication
Medicaid Expansion has ushered in new challenges for those working in the Medicaid Industry. At the 2014 Medicaid Summit, join Medicaid Directors and industry leaders to discuss solutions to the challenges that are surfacing with Medicaid Expansion. Be a part of the discussions on the Medicaid regulations and access to care and their impact on the Medicaid industry for state operators, providers and Medicaid health plans.
http://bit.ly/MedicaidSummit
Disparities in Health Care: The Significance of Socioeconomic StatusAmanda Romano-Kwan
This research paper discusses the disparities in the health care system, with a specific focus on socioeconomic status and how it affects the access and availability of quality care.
This report contains information on Ventura County and the different benefits and drawbacks of its different health care services. It is intended as an overview of Ventura County’s health status.
Universal health coverage as a concept was born in 1883 when Germany introduced health coverage for achieving health status of its young population.India, is still attempting to find a way for providing appropriate, affordable and accessible health care to its population.
Masahiko Hayashi: Long-term care insurance in JapanNuffield Trust
In this slideshow, Masahiko Hayashi, Deputy Assistant to the Minister for International Affairs, Ministry of Health, Labour and Welfare, Japan, provides an overview of long-term care insurance in Japan and considers its’ future.
The 2014 Medicare Summit will feature a comprehensive, timely offering of sessions focused on key issues currently impacting the industry including the Dual Eligible population, ACOs, the sustainable growth rate, Medicare Advantage and star ratings. As the landscape of healthcare policy and reform continues to change at a rapid pace, it is imperative for hospitals, health systems, physicians, administrators, and health plans to stay well-informed so they can remain profitable.
http://www.worldcongress.com/events/HL14026/
Kehidupan kupu-kupu mengalami metamorfosa, dan ini menggambarkan perjalanan kehidupan termasuk manusia yang penuh dengan perjuangan untuk meraih kemenangan dan kebahagiaan yang sebenarnya.
Bibliographie sur la couverture sanitaire universelle - AfHEAHFG Project
On October 28, Health Systems Global (HSG)’s Translating Evidence into Action Working Group hosted a webinar on a regional initiative to empower public and private leaders in Francophone Africa with evidence and research related to universal health coverage (UHC). In response to calls for UHC reforms in the region, the African Health Economics and Policy Association (AfHEA) has trained over 45 policymakers and other stakeholders from 16 countries across Francophone Africa to address their urgent need for relevant evidence and knowledge to advance their country’s progress towards UHC. Training participants were self- or employer- financed, and came from Ministries of Health, quasi-governmental agencies (social security agencies, health insurance), or were young African researchers, analysts, and activists in civil society.
The webinar focused on how AfHEA made the wealth of evidence on financing and structuring UHC in English, accessible in French (What did policy makers need to make UHC policy and how did AfHEA get it to them successfully?) and how the training participants continue to support each other in using evidence to inform policy (Where do policymakers go for evidence or technical support and what is most useful to them?). The hour-long webinar—held in French with a separate line for simultaneous English translation—saw over 50 participants and featured four speakers.
Speakers:
Pascal Ndiaye, Health Finance and Policy Specialist, AfHEA (Moderator)
Miloud Kaddar, Senior Health Economist, World Health Organization (Panelist)
Marie Nome Essoh Lattroh, Technical Adviser, Ministry of Economy and Finance, Senegal (Panelist)
Hugues B.M. Tchibozo, Deputy Director General, National Health Insurance Agency, Ministry of Health, Benin (Panelist)
The panel included training participants (Ms. Lattroh and Mr. Tchibozo), an instructor (Mr. Kaddar), and an organizer (Mr. Ndiaye). The diverse experiences provided for a rich panel and discussion.
Major takeaways from the webinar:
The increased global focus on UHC represents an opportunity to advance policies and strategies for extending health care access to vulnerable populations across Africa.
UHC should be a medium to long term goal requiring a health systems approach and sustained engagement by all actors and stakeholders.
There is no single source of funding for UHC.
Resolving shortages and unequal distribution of the health workforce in Africa is essential for achieving UHC.
While the term “universal” signals that the entire population will be “covered,” an unanswered question is: covered with what? What benefits or interventions represent “coverage”?
The importance and diversity of the informal sector requires special attention. Policies must be based on context-specific evidence of what works.
A Comparative Analysis Of The UK And US Health Care Systemsabbiemc
- Published a comparative review of health systems of the National Health Service in the United Kingdom and the varying approaches to health systems in the United States
- Developed research question, conducted interviews, utilized PubMed and similar research database systems, performed literature review, and prepared and submitted for publication
Medicaid Expansion has ushered in new challenges for those working in the Medicaid Industry. At the 2014 Medicaid Summit, join Medicaid Directors and industry leaders to discuss solutions to the challenges that are surfacing with Medicaid Expansion. Be a part of the discussions on the Medicaid regulations and access to care and their impact on the Medicaid industry for state operators, providers and Medicaid health plans.
http://bit.ly/MedicaidSummit
Disparities in Health Care: The Significance of Socioeconomic StatusAmanda Romano-Kwan
This research paper discusses the disparities in the health care system, with a specific focus on socioeconomic status and how it affects the access and availability of quality care.
This report contains information on Ventura County and the different benefits and drawbacks of its different health care services. It is intended as an overview of Ventura County’s health status.
Universal health coverage as a concept was born in 1883 when Germany introduced health coverage for achieving health status of its young population.India, is still attempting to find a way for providing appropriate, affordable and accessible health care to its population.
Masahiko Hayashi: Long-term care insurance in JapanNuffield Trust
In this slideshow, Masahiko Hayashi, Deputy Assistant to the Minister for International Affairs, Ministry of Health, Labour and Welfare, Japan, provides an overview of long-term care insurance in Japan and considers its’ future.
The 2014 Medicare Summit will feature a comprehensive, timely offering of sessions focused on key issues currently impacting the industry including the Dual Eligible population, ACOs, the sustainable growth rate, Medicare Advantage and star ratings. As the landscape of healthcare policy and reform continues to change at a rapid pace, it is imperative for hospitals, health systems, physicians, administrators, and health plans to stay well-informed so they can remain profitable.
http://www.worldcongress.com/events/HL14026/
Kehidupan kupu-kupu mengalami metamorfosa, dan ini menggambarkan perjalanan kehidupan termasuk manusia yang penuh dengan perjuangan untuk meraih kemenangan dan kebahagiaan yang sebenarnya.
The Texas Department of Insurance can lower the costs for chronic disease healthcare by partnering with local public health agency chronic disease programs
HIV in USA
Outline:
The universal health coverage in US
Health policy in USA.
Comment about the individualism Vs collectivism in US.
Discuss main risk factors for CVD and the strategy to counter these risks.
Absolute contra-indications for liver transplantation.
Incidence, prevalence, & mortality of HIV/AIDS.
Overview - Health Care IssuesHealth Care IssuesOpposing .docxgerardkortney
Overview - Health Care Issues
Health Care Issues
Opposing Viewpoints Online Collection, 2015
In recent years, the availability and affordability of health insurance in the United States has become
the subject of much debate. The United Nations’ Universal Declaration of Human Rights lists medical
care among the basic human rights to which all people are entitled. In 2011, however, about 17
percent of Americans had no health insurance at all. For many people who are insured, the cost of
coverage is a financial hardship. This situation has led some people to call for the government to
provide health insurance for all citizens. Others, however, are skeptical of government’s ability to
efficiently manage health insurance and oppose any plans that involve government. The issue is made
more urgent by rapidly rising health care costs that threaten to overwhelm the country’s current
system of health insurance, and the national economy in general. Health care reform has become one
of the most important issues in contemporary American politics.
The Basics of Health Care
In most developed countries, health care systems involve government control or sponsorship. For
instance, in Great Britain, Scandinavia, and the countries of the former Soviet Union, the government
controls almost all aspects of health care, including access and delivery. For the most part, health
services in these countries are free to everyone; the systems are financed primarily by taxes. Other
countries, such as Germany and France, guarantee health insurance for almost all their citizens, but
the government plays a smaller role in managing health care. Both systems are financed at least in
part by taxes on wages.
The US government, by contrast, does not pay for most of its citizens’ health care. Generally,
Americans receive health care through employer-sponsored insurance, or they arrange to pay for
insurance on their own. Like all forms of insurance, health insurance operates by pooling the
resources of a group of people who face similar risks. This creates a common fund that members can
draw upon when needed. Each person in the group pays a certain amount, called a premium, every
month. These premiums are used to cover the medical expenses of group members who become sick
or injured.
Health Insurance in the United States
Today, most Americans receive health insurance through their place of work. Employers typically pay
for part of the premiums. Most employer-sponsored plans are administered through payroll
contributions. People who are self-employed and those whose employers do not provide health
insurance must purchase individual health insurance. Individual plans are generally more expensive
than group plans. Certain low-income individuals and families may be eligible for Medicaid, a form of
government-sponsored health insurance. In 1997, the US government introduced the Children’s
Health Insurance Program (CHIP) to assist the children of families who do not qualify f.
Assessing U.S. and International Experience with Health Reform and Implications for the Future by W. David Helms, Ph.D, President and CEO, Academy Health
Online Journal of Health EthicsVolume 1 Issue 1 Article .docxcherishwinsland
Online Journal of Health Ethics
Volume 1 | Issue 1 Article 5
Universal Healthcare in America
Sandra Carr Hayes
University of Mississippi Medical Center
Follow this and additional works at: http://aquila.usm.edu/ojhe
This Article is brought to you for free and open access by The Aquila Digital Community. It has been accepted for inclusion in Online Journal of Health
Ethics by an authorized administrator of The Aquila Digital Community. For more information, please contact [email protected]
Recommended Citation
Hayes, S. C. (2004). Universal Healthcare in America. Online Journal of Health Ethics, 1(1).
http://dx.doi.org/10.18785/ojhe.0101.05
http://aquila.usm.edu/ojhe?utm_source=aquila.usm.edu%2Fojhe%2Fvol1%2Fiss1%2F5&utm_medium=PDF&utm_campaign=PDFCoverPages
http://aquila.usm.edu/ojhe/vol1?utm_source=aquila.usm.edu%2Fojhe%2Fvol1%2Fiss1%2F5&utm_medium=PDF&utm_campaign=PDFCoverPages
http://aquila.usm.edu/ojhe/vol1/iss1?utm_source=aquila.usm.edu%2Fojhe%2Fvol1%2Fiss1%2F5&utm_medium=PDF&utm_campaign=PDFCoverPages
http://aquila.usm.edu/ojhe/vol1/iss1/5?utm_source=aquila.usm.edu%2Fojhe%2Fvol1%2Fiss1%2F5&utm_medium=PDF&utm_campaign=PDFCoverPages
http://aquila.usm.edu/ojhe?utm_source=aquila.usm.edu%2Fojhe%2Fvol1%2Fiss1%2F5&utm_medium=PDF&utm_campaign=PDFCoverPages
http://dx.doi.org/10.18785/ojhe.0101.05
mailto:[email protected]
Universal Healthcare
1
Universal Healthcare in America
Sandra Carr Hayes
University of Mississippi Medical Center
Keywords:
Health care; Universal Healthcare; Healthcare Access; National Health; Health Costs
Abstract
Lack of health care insurance, once thought to be a problem of the poor, and has
now begun to affect a new population- the middle class. The major factors
contributing to this are increased deductibles and co-payments, cost shifting and
the introduction of managed care networks. The idea of a universal health plan has
been introduced several times over the last few decades. With the introduction of
Medicare and Medicaid came the promise of a more inclusive health care plan for
all Americans. However, Medicare and Medicaid remain largely unchanged from
what they were when they were first introduced in 1965. The U. S. was built on the
foundation of ‘unalienable rights’. Why then is the number of uninsured and
uninsured rising and projected to continue rising? This article seeks to explore
these questions.
Universal Healthcare
2
Universal Healthcare in America
Introduction
One in six Americans doesn’t have health insurance. Studies have shown that health
insurance and poverty are the strongest determinants of access to health services
(Guendelman, et. al, 1986). The uninsured are less likely to obtain medical attention
when they have a perceived "need for care". This is best illustrated in the case of
George and Tina. George and Tina were siblings who had been diagnosed with
diabetes in childhood. However, their disease went un.
CHAPTER 1History of the U.S. Healthcare SystemLEARNING OBJECTI.docxmccormicknadine86
CHAPTER 1
History of the U.S. Healthcare System
LEARNING OBJECTIVES
The student will be able to:
■ Describe five milestones of medicine and medical education and their importance to health care.
■ Discuss five milestones of the hospital system and their importance to health care.
■ Identify five milestones of public health and their importance to health care.
■ Describe five milestones of health insurance and their importance to health care.
■ Explain the difference between primary, secondary, and tertiary prevention.
■ Explain the concept of the iron triangle as it applies to health care.
DID YOU KNOW THAT?
■ When the practice of medicine first began, tradesmen such as barbers practiced medicine. They often used the same razor to cut hair as to perform surgery.
■ In 2014, the United States spent 17.5% of the gross domestic product on healthcare spending, which is the highest in the world.
■ As a result of the Affordable Care Act, the number of uninsured is projected to decline to 23 million by 2023.
■ The Centers for Medicare and Medicaid Services predicts national health expenditures will account for over 19% of the U.S. gross domestic product.
■ The United States is the only major country that does not have universal healthcare coverage.
■ In 2002, the Joint Commission issued hospital standards requiring them to inform their patients if their results were not consistent with typical care results.
▶ Introduction
It is important as a healthcare consumer to understand the history of the U.S. healthcare delivery system, how it operates today, who participates in the system, what legal and ethical issues arise as a result of the system, and what problems continue to plague the healthcare system. We are all consumers of health care. Yet, in many instances, we are ignorant of what we are actually purchasing. If we were going to spend $1,000 on an appliance or a flat-screen television, many of us would research the product to determine if what we are purchasing is the best product for us. This same concept should be applied to purchasing healthcare services.
Increasing healthcare consumer awareness will protect you in both the personal and professional aspects of your life. You may decide to pursue a career in health care either as a provider or as an administrator. You may also decide to manage a business where you will have the responsibility of providing health care to your employees. And last, from a personal standpoint, you should have the knowledge from a consumer point of view so you can make informed decisions about what matters most—your health. The federal government agrees with this philosophy.
As the U.S. population’s life expectancy continues to lengthen—increasing the “graying” of the population—the United States will be confronted with more chronic health issues because, as we age, more chronic health conditions develop. The U.S. healthcare system is one of the most expensive systems in the world. According to 2014 statistics, the ...
Peter L. Slavin, M.D., 2015 Leadership in Academic Medicine Lectureuabsom
Peter L. Slavin, M.D., president of Massachusetts General Hospital, presented “The Future of Academic Medicine” on Thursday, Aug. 6 as the featured speaker for the 2015 Leadership in Academic Medicine Lecture, sponsored by UAB Medicine.
A quick description of American and Canadian Healthcare similarities and differences. I was born in Canada and raised in the US, so it was really interesting to me to know the differences between the two and compare to what I remember prior to becoming a US citizen.
MMS State of the State Conference: Susan Dentzer - Rationalizing Health Spend...
The Truth About Prevention
1.
2. Truth #1: A substantial cause of rising health care spending is preventable or poorly managed chronic disease 99% of Medicare expenditures are spent treating patients with one of more chronic diseases Two-thirds of the rise in health care spending is due to the rise in treated chronic diseases. Many cases could be prevented. Most could be better managed. 2/3 1/3 One-third of the rise alone is due to obesity 2 Source: Health Affairs, AHRQ, other calculations
3. Truth #2: The U.S. spends very little on prevention, despite behavioral and environmental factors accounting for 70 percent of U.S. deaths U.S. Investment in Prevention Causes of Avoidable Mortality 30% - Other Contributors (genetics, health care, etc.) 70% - Behavioral and Environmental Factors 1% - 3%- Prevention 97 % - 9% - Medical Care and Biomedical Research 3 Source: Institute of Medicine, Health Affairs, Journal of American Medical Association (JAMA)
4. Truth #3: Americans strongly support prevention in health reform, above many proposals regarding coverage Support Among Americans for Policy Solutions in Health Reform 70% of Americans rank investing in prevention as the number one health reform priority, above proposals regarding coverage or affordability 4 Source: Robert Wood Johnson Foundation and Trust for America’s Health
13. Sleep apnea and respiratory problemsAge-adjusted* prevalence of overweight and obesity among U.S. adults among U.S. adults, age 20 years and over Overweight or obese (BMI greater than or equal to 25.0) Obese (BMI greater than or equal to 30.0) 1988-1994 1999-2000 2003-2004 5 Source: Centers for Disease Control and Prevention (CDC)
14. Truth #5: Some costs can be avoided altogether by averting disease through reducing or eliminating risk factors Projected Lifetime Medicare Health Care Expenditures for a Cohort of Seventy-Year-Olds, 2004 Dollars FACT: Medicare will spend about 34% more on an elderly obese person over their lifetime* than on someone of normal weight, even though they will live about as long. *Lifetime costs refer to costs incurred between Medicare enrollment and death $36,886 = difference in lifetime Medicare spending between obese and normal weight American senior citizens 6 Source: Health Affairs
15. Truth #6: Prevention is often defined inaccurately and incompletely, focusing on a specificcategory rather than the comprehensive definition Prevention Encompasses Three Major Areas with Specific Goals Primary Prevention Secondary Prevention Tertiary Prevention Goal: Manage Disease to Avoid Complications and Disease Progression Goal: Find and Treat Disease in Its Earliest Stages to Stop Its Progression Goal: Reduce or Eliminate Risk Factors and Avert Disease Following treatment recommendations Risk-based screenings Eating healthy Blood tests and other monitoring Health coaching Getting exercise Transitional care Avoiding unhealthy behaviors Taking steps to reduce risks Care coordination models Most people define prevention as this category only, even though it encompasses all three Vaccines 7
16. Truth #7: Many Americans are not receiving the preventive care they need, resulting in preventable cases that can lead to costly complications Example: Diabetes Prevention in United States 5.2 million have their disease CONTROLLED 57 million Americanshave PRE-DIABETES 24 million Americans have DIABETES 13 million of those are TREATED 17 million of those are DIAGNOSED Goal: Reduce or Eliminate Risk Factors and Avert Disease 7 million are UNDIAGNOSED 4 million are diagnosed but NOT TREATED 7.8 million are treated but NOT SUCCESSFULLY CONTROLLED 18.8 million have diabetes that is NOT CONTROLLED Goal: Find and Treat Disease in Its Earliest Stages to Stop Its Progression Goal: Manage Disease to Avoid Complications and Disease Progression Goal: Manage Disease to Avoid Complications and Disease Progression Goal: Avert Onset of Diabetes or Costs due to Untreated or Uncontrolled Disease 8 Source: NIH, CDC
17. Truth #8: To be most effective, prevention must be comprehensive Examples of existing policy proposals Type of prevention Community health teams (CHTs) Economic incentives to individuals and employers to promote wellness Grants for community-based wellness programs Immunizations Primary Community health teams (CHTs) Accountable health organizations (AHOs) Reducing cost-sharing on preventive services in Medicare A & B “Right Choices” program Secondary Community health teams (CHTs) Accountable health organizations (AHOs) Care coordination programs (i.e., medication therapy management (MTM),transitional care) Low or nominal co-pays for prescription drugs to manage chronic conditions Tertiary 9
18. Truth #9: Programs exist that are demonstrating cost savings through prevention Example of Primary Prevention: Healthways Silver Sneakers Program Cost Savings Target Population Summary Seniors enrolled in a Medicare Advantage plan that provides a health club membership. Participants who visited a health club at least twice a week incurred $1,252 less in health expenses per year, on average, than those who visited less than once a week. Participants receive access to a state-of-the-art fitness center, customized fitness classes designed exclusively for older adults and health education seminars and events that promote the benefits of a healthy lifestyle. Total Individual Annual Savings: $1,252 10 Source: CDC For more information visit: http://www.cdc.gov/pcd/issues/2008/jan/07_0148.htm
19. Truth #9: Programs exist that are demonstrating cost savings through prevention Example of Secondary Prevention: Caterpillar, Inc. Healthy Balance Cost Savings Target Population Summary Over a 3-year period, average per person claims costs were $16,121 lower for participants than non-participants. Employees (80,000) and others covered by Caterpillar health plans (120,000 total). The employee wellness program utilizes health risk assessments to detect health risks early and then creates a customized disease prevention or management health plan for each employee. Total Annual Claims Savings: $16,121 Source: The Health Project, C. Everett Koop For more information visit: http://healthproject.stanford.edu/koop/work.html
20. Truth #9: Programs exist that are demonstrating cost savings through prevention Example of Tertiary Prevention: The Diabetes Ten Cities Challenge Cost Savings Target Population Summary Average annual savings of almost $1,100 in total health care costs per patient. Participants receive voluntary health benefit, waiver for diabetes medications and supplies co-pays and a specially-trained pharmacist "coach". Diabetic employees, dependents and retirees of the city government. Total Individual Annual Savings: $1,101 12 Source: American Pharmacists Association Foundation For more information visit: http: http://www.diabetestencitychallenge.com
21. Sources Truth #1: Two-thirds of the rise in health care spending from 1987-2006 is due to the rise in the prevalence of treated chronic disease Source: Thorpe K. “The Rise In Health Care Spending And What To Do About It.” Health Affairs. 2005. Also, Thorpe K, Florence CS, Joski P. “Which Medical Conditions Account For The Rise In Health Care Spending?” Updated by Author using Medical Expenditures Panel Survey. AHRQ. 2007. Accessed at: http://www.meps.ahrq.gov/mepsweb/index.jsp. 99 cents of every dollar spent in Medicare is spent treating patients with chronic disease Source: Partnership for Solutions. Chronic Conditions: Making the Case for Ongoing Care. September 2004. Truth #2: U.S. Investment in Prevention, Causes of Avoidable Mortality Source: Institute of Medicine. 200 3. The Future of the Public’s Health in the 21stCentury. Washington, D.C.: The National Academies Press . Citing: McGinnis JM, Williams-Russo P, Knickman JR. 2 002. “The Case for More Active Policy Attention to Health Promotion.” Health Affairs 21:78 -93 and McGinnis GM, Foege WH. 1993. “Actual Causes of Death in the United States .” JAMA 27 0(18): 2207-2212. Truth #3: Americans strongly support prevention in health reform, above many proposals regarding coverage Source: June 2009 Survey. Robert Wood Johnson Foundation and Trust for America’s Health. Accessed at http://healthyamericans.org/assets/files/health-reform-poll-memo.pdf Truth #4: Obesity rates have increased sharply and contribute to the rising rate of associated chronic diseases Source: National Center for Health Statistics. “Prevalence of Overweight and Obesity Among Adults: United States, 2003-2004. Available at: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/overweight/overwght_adult_03.htm 13
22. Sources Continued Truth #5: Projected Lifetime Medicare Health Care Expenditures for a Cohort of Seventy-Year-Olds, 2004 Dollars Source: Darius N. Lakdawalla, Dana P. Goldman, and Baoping Shang. “The Health And Cost Consequences Of Obesity Among The Future Elderly.” Health Affairs. September 2005. Accessed at: http://content.healthaffairs.org/cgi/reprint/hlthaff.w5.r30v1 Truth #7: 2 in 3 adults are obese or overweight Source: “Statistics related to Overweight and Obesity” Weight Control Intervention Network, NIH Accessed at: http://win.niddk.nih.gov/statistics/ 1 in 12 Americans have diabetes Source: “Number of People with Diabetes Increases to 24 Million” CDC http://www.cdc.gov/media/pressrel/2008/r080624.htm Truth #9: Primary Prevention: Healthways Silver Sneakers Source: “Managed-Medicare Health Club Benefit and Reduced Health Care Costs Among Older Adults” CDC Accessed at: http://www.cdc.gov/pcd/issues/2008/jan/07_0148.htm Secondary Prevention: Caterpillar, Inc. Healthy Balance Source: C. Everett Koop. “The Health Project.” Accessed at: http://healthproject.stanford.edu/koop/work.html Tertiary Prevention: The Diabetes Ten Cities Challenge Source: American Pharmacists Association Foundation, Accessed at: http://www.diabetestencitychallenge.com/ 14