Transcript Health Reform and Public Health
The Affordable Care Act and Public Health
Andrew S. Rein Associate Director for Policy Centers for Disease Control and Prevention April 20, 2011 National Tribal Health Reform Implementation Summit
More Than Coverage, Quality, and Cost… The Affordable Care Act is a Real Opportunity for Public Health
Public Health Pillars of the Affordable Care Act
Preventive services without cost sharing
Policies and programs
Prevention and Public Health Fund
National Prevention Strategy
More People Will Have Access to Preventive Services
Preventive services covered with no cost sharing
USPSTF, ACIP, Bright Futures, and women’s health guidelines and recommendations Private insurance, Medicare Incentive for states to include in Medicaid
Medicare wellness visit
Review medical history, current care Health risk assessment Routine measurements, e.g., BMI
Nationwide Menu Labeling Puts Information in Consumers’ Hands
Calories listed on menus and menu boards
Restaurants and retail food establishments with 20 or more locations Other nutrient information (e.g., saturated fat, cholesterol, sodium, carbohydrates, sugars, fiber, protein) available in writing upon request
Calories listed for vending machine items
Operators who own or operate 20 or more machines
Prevention and Public Health Fund Provides Sustainable Funding
Grows from $500m to $2b annually 2010 $500m 2011 $750m 2012 $1b 2013 $1.25b
2014 $1.5b
2015-19 $2b
2010
$250m for primary care workforce $250m for prevention and public health
2011
$750m for community and clinical prevention, public health infrastructure, and research and tracking
PPHF Prevents Disease, Improves Health, and Saves Money
Empower communities to prevent the leading causes of death – heart attacks, cancer, stroke, injuries, and more
Improve health protection agencies’ capacity to detect and control threats
Identify and monitor health system’s successes and challenges
PPHF – CDC FY10 Investments Investment area NPHII CPPW HIV ELC / EIP Healthcare surveillance Tobacco media Public health workforce Tobacco quit lines Community Guide ARRA evaluation ARRA media Total Amount $50m $36.4m
$30.3m
$20m $19.8m
$9.5m
$7.5m
$5m $5m $4m $4m $191m
CDC FY10 PPHF Funding to Tribes Tribe NPHII Funding Alaska Native Tribal Health Consortium Cherokee Nation Gila River Indian Community Mille Lacs Band Of Ojibwe Indians Montana Wyoming Tribal Leaders Council Navajo Nation Division Of Health Northwest Portland Area Indian Health Board Southeast Alaska Regional Health Consortium HIV Funding Indian Health Service Total Amount $100,000 $1,760,128 $100,000 $99,866 $100,000 $100,000 $100,000 $100,000 $1,000,000 $3,459,994
PPHF – Prevent Leading Causes of Death
Empower communities to prevent heart attacks, cancer, stroke, injuries, and more
Communities Putting Prevention to Work Increase tobacco cessation and reduce initiation Curb HIV epidemic through enhanced laboratory capacity, surveillance, testing, care and treatment, and prevention Community Transformation Grants Chronic Disease Grants Immunization
PPHF – Strengthen Public Health Detection and Response
Critical to stop outbreaks and prepare for and stop natural or terrorist disasters
State and local detection and response
Increase capacity to use resources efficiently
Epi and lab capacity to detect and respond
Test for food borne diseases, flu, etc., and analyze data quickly
Skilled workforce to address complex public health demands
Front line workers, epidemiologists and more – next generation leaders
Healthcare Associated Infections
Reduce infections, save lives and reduce costs of treatment and unnecessary hospital readmission
PPHF – Produce information for Action
Know what prevention programs work and track health system performance—increase health value of our health investments
Community Guide
Identify and promote what works
Healthcare Surveillance
Improve access to accurate and timely data on obesity and physical activity, changes in heart attack and stroke care and prevention and more
Prevention Research
National Prevention, Health Promotion, and Public Health Council
Opportunity to prioritize and align prevention efforts across the federal government and the nation
Chaired by the Surgeon General
Council members: 17 federal departments
Advisory Group: 15 non-federal members appointed
Council Members Bureau of Indian Affairs Corporation for National and Community Service Department of Agriculture Department of Defense Department of Education Department of Health and Human Services Department of Homeland Security Department of Labor Department of Transportation Department of Veterans Affairs Environmental Protection Agency Federal Trade Commission Office of Management and Budget Department of Housing and Urban Development Department of Justice Office of National Drug Control Policy White House Domestic Policy Council
National Prevention Council: Charge
Develop the National Prevention Strategy
Provide ongoing leadership and coordination of federal prevention and health promotion efforts
Produce an Annual Status Report
National Prevention Strategy
Identify goals, priorities, and actions for improving health
Ground activities in evidence-based practices
Align and focus federal prevention and health promotion activities
Align with existing national efforts, such as:
–
Let’s Move!
–
Healthy People 2020
–
National Quality Strategy
–
America’s Great Outdoor Initiative
Approach
Work across sectors
Catalyze public and private partnerships:
Federal, state, tribal, local, and territorial
Private, non-profit, faith, community, labor
Focus on where people live, learn, work, and play
Community, worksite, institutions, etc.
Promote healthy development and behaviors throughout all stages of life
Eliminate disparities
Stakeholder Engagement
National conferences
Stakeholder input sessions
Outreach calls
HHS Regional meetings
Council website: www.healthcare.gov/nationalpreventioncouncil
Draft Vision Working together to improve the health and quality of life for individuals, families, and communities by moving the nation from a focus on sickness and disease to one based on wellness and prevention .
Draft Goal and Pillars
Americans Living Healthier and Longer
Healthy Communities Preventive Clinical and Community Efforts Empowered Individuals Eliminate Health Disparities
Draft Priorities
Healthy Physical, Social and Economic Environments
Prevention and Public Health Capacity
Quality Clinical Preventive Services
Tobacco-Free Living
Preventing Excessive Alcohol and Other Substance Abuse
Healthy Eating
Active Living
Injury-Free Living
Sexual Health
Mental and Emotional Wellbeing