The Affordable Care Act (ACA) is a historic law and its third birthday should be celebrated.
The law, each day, helps move the country from a 'sick care' system
to a real health care system. Some of the lesser known but most
important provisions of the ACA focus on preventing disease instead of
treating people only after they become ill. Millions of Americans are
already healthier because of the prevention portions of the law,
including Community Transformation Grants (CTG), expanded coverage of
preventive services and other measures focused on improving health in
the ACA.
The law has also ensured that:
- Every new health plan, beginning in 2010, must
include coverage of evidence-based, effective preventive services, such
as screenings for type 2 diabetes, immunizations and mammograms, without
co-pays;
- Seniors on Medicare receive many preventive services, starting
January 1, 2011, with no co-payments - these services include annual
wellness visits, cervical cancer screening, diabetes screening,
mammograms and important immunizations such as for the flu and
pneumonia; and
- The Prevention and Public Health Fund will invest $12.5
billion over 10 years (FY2013-FY2022) in locally-determined,
evidence-based community prevention programs and will support public
health job creation and training programs. The Fund will provide a
coordinated, comprehensive, sustainable and accountable approach to
improving the nation's health outcomes through the most effective
prevention and public health programs.
One of the law's great prevention successes is the CTGs program -- one
of the hallmark initiatives of the Prevention and Public Health Fund.
CTGs provide communities with resources to focus on their top health
priorities, including smoking cessation and obesity prevention.
In just three short years, the law has been an enormous benefit to
Americans. In 2011, the Centers for Disease Control and Prevention (CDC)
awarded
$103 million
in CTGs to 61 state and local public health or related organizations,
and, in 2012, CDC funded CTG programs with $226 million, including
approximately $70 million in CTG funding to 40 additional communities.
To commemorate the third anniversary of the Affordable Care Act, we
at the Trust for America's Health (TFAH) released a story bank featuring
stories of successful prevention initiatives in action from around the
country. Many of the stories focus on CTG awardees and show how this
new program, made possible by the ACA, is already helping to improve the
health of Americans. TFAH's
Prevention and Public Health Stories in the States story bank includes more than 50 profiles in 28 states, including:
- The launch of the first Accountable Care Community (ACC)
in Akron, Ohio, which builds on the idea of an Accountable Care
Organization. In 2011, the nonprofit organization Austen BioInnovation
Institute (ABIA) brought together a wide range of 70 different groups to
coordinate health care inside and outside the doctor's office for
patients with type 2 diabetes, and received500,000 per year for 5 years
for a capacity building CTG. The ACC reduced the average cost per month
of care for individuals with type 2 diabetes by more than 10 percent
per month over 18 months with an estimated program savings of3,185 per
person per year. This initiative has also led to a decrease in
diabetes-related emergency department visits.
- Oklahoma is using a CTG to
work with a range of sectors to make healthier choices easier in the
state. Nearly 70 percent of Oklahoma County's premature deaths are
largely preventable, and the county spends about920 million every year
to treat chronic disease. In September 2011, Oklahoma City was awarded
a3.5 million CTG. Using a portion of those funds, along with additional
outside resources, the Oklahoma City-County Health Department (OCCHD)
created the "My Heart, My Health, My Family" program to provide
prevention programs and services, specifically focused on cardiovascular
disease. The CTG money will also support expanded walking and biking
trails, a push to help schools offer healthy menu options and a physical
education coordinator for city schools.
- Operation UNITE
(Unlawful Narcotics Investigations, Treatment and Education) in
Kentucky received a capacity-building CTG to help support this program
which has delivered important results for a holistic, community-based
approach to address substance abuse. UNITE was created a decade ago,
however the CTG will help expand its work to support public health
efforts aimed at reducing chronic diseases, promoting healthier
lifestyles, reducing health disparities and controlling health care
spending, and will serve 119 of the state's 120 counties. UNITE works
to rid communities of illegal drug use and misuse of prescription drugs
by coordinating treatment, providing support to families and friends and
educating the public about the dangers of drug abuse.
- The West Virginia Department of Health
is using CTG support to help local health departments in every county
in the state implement targeted initiatives including: safe places in
communities to work and play, Farm-to-School Initiatives to improve
nutrition in school settings, Child and Day Care Center Nutrition
Programs to educate and empower children to choose healthy lifestyles
through physical activity and healthy food choices, and community
coordinated care systems that link and build referral networks between
the clinical system and community-based lifestyle programs so people can
manage their health.
The ACA began a new era for public health. The law paves the way
toward ensuring public health is no longer separated from the rest of
the health care system. The ACA supports common-sense community
approaches focused on connecting the care people receive in the doctor's
office with opportunities to stay healthier beyond the doctor's office,
where we all live, learn, work and play.
As the Affordable Care Act continues to benefit the country, in
another year, we'll have an abundance of stories to share of communities
turning their health around by focusing on preventing illness and
thereby creating happy, healthy and thriving neighborhoods.
Jeffrey Levi, PhD
Associate professor of health policy, George Washington University
(This article was originally posted in the Huffington Post blog
here.)
