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Prevention is More than a Promise

John Seffrin, Larry Hausner and Nancy Brown of the American Cancer Society, American Diabetes Association and American Heart Association, respectively, recently wrote an op-ed about how the new health care law’s prevention and early detection programs have the potential to transform our health care system and drastically reduce the rates of chronic disease in the U.S.

I couldn’t agree more and want to reiterate a point I’ve made before—preventing disease and managing it effectively will significantly reduce our national health care spending. Our health care delivery system needs more care coordination in order to effectively and efficiently prevent and manage chronic disease.

Community health teams and accountable care organizations—two extremely effective care coordination models—are a vital link to refer patients to community-based prevention programs that can deliver effective primary care to avert disease, detect existing conditions and help avoid complications from one or more chronic conditions. Several states have implemented variations of the CHT model, further evidence of its scalability at a national level.

Care coordination is especially important in Medicare. Federal spending in 2008 in Medicare and Medicaid on patients with one or more chronic condition was $568.4 billion. To put it in perspective, that is more than six times the entire health care budget for the state of California.

Traditional Medicare does not pay for care coordination, as evidenced by high hospital readmission rates—20 percent of Medicare patients are readmitted within 30 days of discharge. This is detrimental to the health of these patients and to our health care system. Increased care coordination in Medicare has the potential to significantly reduce this problem. Using these transitional care models, such as CHT, have the potential to save $12 billion over 10 years.

The most effective way to improve health outcomes and reduce costs is through increased care coordination in our health care system. Community health teams and accountable care organizations are authorized in the health reform law, but have yet to be appropriated by Congress. President Obama and Congress have funded several prevention provisions of the law, including the establishment of the National Prevention, Health Promotion, and Public Health Council, and I encourage them to swiftly allocate funds for care coordination efforts.