Medicare Embraces the ‘Ounce of Prevention’ Philosophy

March 23, 2016
5:20 pm

We’ve long maintained that Medicare can be a stronger program, both in terms of protecting the health of its beneficiaries and in improved cost-efficiency, if it did a better job emphasizing prevention, diagnosis and early treatment, emulating many of the lessons being demonstrated every day in the private sector.

To the credit of HHS Secretary Sylvia Burwell, the Medicare program is now moving in this direction in a very significant way.

Today, Secretary Burwell announced that the Obama Administration will propose new rules this summer that would have Medicare provide coverage for diabetes prevention programs.  She cited a YMCA program that has enabled participants to cut their body weight by an average five percent, thus reducing the propensity for diabetes, a disease with extremely high incidence rates among the elderly.  Early interventions can prevent the need for more expensive healthcare services to treat diabetes symptoms, thus reducing Medicare expenditures.

HLC has long argued that Medicare should pay for services such as health coaching, aiding beneficiaries in practicing better dietary and exercise habits, as well as new technological innovations to help those with diabetes and prediabetes better monitor their health conditions.  We, in fact, sponsored a briefing for congressional staffers on the subject last year.

Secretary Burwell’s announcement today heralded an important new direction for the Medicare program.  In her words, the federal government is transitioning from “treating the sick to preventing the illness.”   We applaud her actions.

Examining Comparative Effectiveness Research and Healthcare’s Future

March 10, 2016
1:23 pm

There is an event taking place next week that I would like to spotlight and recommend.  The National Pharmaceutical Council (NPC) is hosting a webinar on comparative effectiveness research (CER) and its potential effects on healthcare decision-making.  The webinar is taking place on Monday, March 14 from 2 to 3 p.m., ET.  You can register here.

In the webinar, NPC will be discussing the results of its sixth annual survey of healthcare stakeholders regarding CER and its possible impact.  Each year, the Council solicits the views of health care associations, payers, government officials and experts in academia to ascertain how and to what extent CER may be used to shape healthcare decisions and also to better understand the roles of different organizations in the public and private sectors in determining the direction of healthcare research as well as its funding and dissemination.

In the continued movement to strengthen health system value, comparative effectiveness research is an important factor to understand.  Ideally, this work can help clinicians better understand how new treatments can have an optimal effect on their patients.

The webinar will feature experts from NPC and Academy Health, as well as Dr. Joe Selby, the executive director of the Patient-Centered Outcomes Research Institute.  Healthcare organizations would do well to tune in.