Population Health Implications of the Affordable Care Act: Workshop Summary (2013)

 

From the 16 October 2013 summary at Full Text Reports

Source: Institute of Medicine

Population Health Implications of the Affordable Care Act is the summary of a workshop convened in June 2013 by the Institute of Medicine Roundtable on Population Health Improvement to explore the likely impact on population health improvement of various provisions within the Affordable Care Act (ACA). This public workshop featured presentations and discussion of the impact of various provisions in the ACA on population health improvement.

Several provisions of the ACA offer an unprecedented opportunity to shift the focus of health experts, policy makers, and the public beyond health care delivery to the broader array of factors that play a role in shaping health outcomes. The shift includes a growing recognition that the health care delivery system is responsible for only a modest proportion of what makes and keeps Americans healthy and that health care providers and organizations could accept and embrace a richer role in communities, working in partnership with public health agencies, community-based organizations, schools, businesses, and many others to identify and solve the thorny problems that contribute to poor health.

Population Health Implications of the Affordable Care Act looks beyond narrow interpretations of population as the group of patients covered by a health plan to consider a more expansive understanding of population, one focused on the distribution of health outcomes across all individuals living within a certain set of geopolitical boundaries. In establishing the National Prevention, Health Promotion, and Public Health Council, creating a fund for prevention and public health, and requiring nonprofit hospitals to transform their concept of community benefit, the ACA has expanded the arena for interventions to improve health beyond the “doctor’s” office. Improving the health of the population – whether in a community or in the nation as a whole – requires acting to transform the places where people live, work, study, and play. This report examines the population health-oriented efforts of and interactions among public health agencies (state and local), communities, and health care delivery organizations that are beginning to facilitate such action.

Related articles

• Population Health Implications of the Affordable Care Act: Workshop Summary (nap.edu)

 

New Report: Call for President Obama Urged to ‘Remove Public Veil of Ignorance’ Around State of US Health

View larger map at http://gamapserver.who.int/mapLibrary/Files/Maps/PerCapitaUSD_2011.png

From the 29 August 2013 Science Daily article

In a call to action on the sorry comparative state of U.S. health, researchers at Columbia University’s Mailman School of Public Health are urging President Obama to “remove the public veil of ignorance” and confront a pressing question: Why is America at the bottom? The report, published in the journal Science, appeals to the President to mobilize government to create a National Commission on the Health of Americans. The researchers underscore the importance of this effort in order for the country to begin reversing the decline in the comparative status of U.S. health, which has been four decades in the making.

This is not a challenge that can be left to private groups, no matter how well meaning. Drs. Ronald Bayer and Amy Fairchild, both Professors of Sociomedical Sciences, argue, “The health status of Americans is a social problem that demands social solutions.” More is at stake than the U.S. healthcare system, which fails to provide needed care to millions of Americans. “There is a need for bold public policies that move beyond individual behavior to address the fundamental causes of disease,” Bayer and Fairchild conclude.

A January 2013 report by the U.S. National Research Council (NRC) and Institute of Medicine (IOM) ranks the United States last among peer nations in health status and compares it unfavorably to 17 peer countries at almost every stage of the life course. The report, titled “U.S. Health in International Perspective: Shorter Lives, Poorer Health,” emphasizes that socioeconomic causes are the drivers of these outcomes and details the categories in which the U.S. has the worst or next-to-worst results:

• The U.S. has higher rates of adverse birth outcomes, heart disease, injuries from motor vehicle accidents and violence, sexually acquired diseases, and chronic lung disease.
• Americans lose more years of life to alcohol and other drugs.
• The U.S. has the highest rate of infant mortality among high-income countries.
• The U.S. has the second highest incidence of AIDS and ischemic heart disease,
• For decades, the U.S. has experienced the highest rates of obesity in children and adults as well as diabetes from age 20 and up.

Read the entire article here

Related articles

• Call for President Obama to ‘remove public veil of ignorance’ around state of US health (eurekalert.org)

[Free Webcast] Evidence for Violence Prevention Across the Lifespan and Around the World-A Workshop

Found this while “surfing” the Institute of Medicine Web page (the primary source for an article in one of my RSS feeds).
I think I share a concern with gun violence with many of you dear readers.There has to be a better way to prevent gun violence than simply arming more folks. For example, a school system to the west of my hometown of Toledo, OH believes arming its janitors will curb violence. (Montpelier schools OKs armed janitors***). My gut reaction? If I had children in the school I would  pull them out. Homeschool them if there were no other ways to educate them. And if the teachers were armed? Same reaction.

Meanwhile I’m going to be participating in a [local] Community Committee Against Gun Violence (MoveOn.org). For the past several years I’ve been very concerned about gun violence. Time to start to do something…hopefully not too late.

Yes, this webcast might be viewed as just another talking heads exercise. I am hoping some good will come out of it. If nothing else, keep a conversation alive on how to address prevention of violence through nonviolence.

Here’s some information about the Webcast directly from the Institute of Medicine web site

Evidence for Violence Prevention Across the Lifespan and Around the World-A Workshop

When: January 23, 2013 – January 24, 2013 (8:00 AM Eastern)

Where: Keck Center (Keck 100) • 500 Fifth St. NW, Washington, DC 20001 Map

Topics: Global Health, Children, Youth and Families, Substance Abuse and Mental Health, Public Health

Activity: Forum on Global Violence Prevention

Boards: Board on Global Health, Board on Children, Youth, and Families

This workshop will be webcast. Register to attend in-person or register to watch the webcast.

  [My note…registration is now closed for in-person attendance, they’ve reached seating capacity]

Evidence shows that violence is not inevitable, and that it can be prevented. Successful violence prevention programs exist around the world, but a comprehensive approach is needed to systematically apply such programs to this problem.  As the global community recognizes the connection between violence and failure to achieve health and development goals, such an approach could more effectively inform policies and funding priorities locally, nationally, and globally.

The Institute of Medicine (IOM) will convene a 2-day workshop to explore the evidentiary basis for violence prevention across the lifespan and around the world. The public workshop will be organized and conducted by an ad hoc committee to examine: 1) What is the need for an evidence-based approach to violence prevention across the world? 2) What are the conceptual and evidentiary bases for establishing what works in violence prevention? 3) What violence prevention interventions have been proven to reduce different types of violence (e.g., child and elder abuse, intimate partner and sexual violence, youth and collective violence, and self-directed violence)?  4) What are common approaches most lacking in evidentiary support? and 5) How can demonstrably effective interventions be adapted, adopted, linked, and scaled up in different cultural contexts around the world?

The committee will develop the workshop agenda, select and invite speakers and discussants, and moderate the discussions. Experts will be drawn from the public and private sectors as well as from academic organizations to allow for multi-lateral discussions. Following the conclusion of the workshop, an individually-authored summary of the event will be prepared by a designated rapporteur.

Related articles

• Comprehensive public health approach urged to curb gun violence in U.S. (mwoods228.wordpress.com)
• Harvard Researchers: Tackle Gun Violence Like Smoking, Car Deaths (wbur.org)
• Biden: Executive action can be taken on guns (politico.com)
• Vice President Biden Meets with Groups to Discuss Violence Prevention (salem-news.com)
• Analyst: No “Single Solution” to Gun Violence (voicerussia.com)
• Comprehensive Public Health Approach Urged to Curb Gun Violence in U.S. (emberbranch.wordpress.com)
• Violence plays role in shorter US life expectancy (newsobserver.com)
• Giffords launches anti-gun violence site (cnn.com)
• Montpelier OKs armed school janitors (toledoblade.com)

 

*** I did respond to the newspaper article. The response is online. I am expecting some rather strong responses, perhaps about how naive I am (sigh).

“Now I know, more than ever, that I have to get more involved in addressing violence through nonviolent means. For starters, am going to get better prepared for a nonviolent workshop our Pax Christi USA section is sponsoring next month. Also am going to do my best to follow through with a local Community Committee Against Gun Violence (http://civic.moveon.org/event/events/index.html?rc=homepage&action_id=302). Guess it’s time to be part of the solution…these two events are steps that are challenging, don’t solve things overnight, but in my heart of hearts…I feel called to participate in actions like these….(am thanking teachers here, esp those at St. Catherine’s(1960-1969) and Central Catholic (1969-1973).”

 

[Reblog]New IOM report focuses on funding health improvement rather than financing health system reform

Posted on April 26, 2012 by sarabeazley at American Hospital Association Resource Center Blog

” . . . it is no longer sufficient to expect that reforms in the medical care delivery system (for example, changes in payment, access and quality) alone will improve the public’s health.”

The Institute of Medicine has issued the third and final report of a series on public health that focuses on how altering the fundamental physical and social environment will lead to improved health in the general population, an essential requirement of any effective reform of the system that delivers health care services.

For the Public’s Health: Investing in a Healthier Future addresses its thesis in four chapter:

• Introduction and Context
• Reforming Public Health and Its Financing
• Informing Investment in Health
• Funding Sources and Structures to Build Public Health

The committee responsible for the report also propose ten recommendations, among which are the following:

• Greater legislative/regulatory flexibility in the allocation of funds by state and local health agencies in pursuit of public health improvement initiatives;
• Reduction in the provision of clinical care services by public health agencies so that they can focus on the delivery of population-based services, such as nurse home visits and health promotion activities;
• Development of  a model chart of accounts for use by public health agencies to improve their tracking of funds and measuring program effectiveness;
• Doubling the current federal appropriation for public health, with periodic adjustments to ensure public health agencies’ ability to deliver a minimum package of services;
• Reallocation of state and local funds from paying for services currently reimbursed through Medicaid or state health insurance exchanges to financing population-based prevention and health promotion initiatives conducted by public health departments.

Source: Institute of Medicine.  For the Public’s Health: Investing in a Healthier Future. Washington, DC: National Academies Press, 2012.  Free online edition at:http://books.nap.edu/openbook.php?record_id=13268.

The two previous reports are also available online.

For the Public’s Health: Revitalizing Law and Policy to Meet New Challenges.  2011. http://www.nap.edu/catalog.php?record_id=13093

or the Public’s Health: The Role of Measurement in Action and Accountability. 2010. http://books.nap.edu/openbook.php?record_id=13005

Related articles

• To Protect U.S. Residents, Physicians Call For Improvements To Country’s Public Health System (jflahiff.wordpress.com)
• Federal agencies should take advantage of opportunities to promote integration of primary care and public health (jflahiff.wordpress.com)
• Public health-related reports from IOM (jflahiff.wordpress.com)
• Competitive advantage: The business case for helping workers and communities become healthier (bangordailynews.com)
• The Guide to Community Preventive Services: What Works to Promote Health (jflahiff.wordpress.com)
• Putting the horse before the cart” A case study of the development of a public policy framework in local government – Public Health (healthycities.wordpress.com)
• Physicians call for improvements to country’s public health system to protect US residents (eurekalert.org)
• Federal agencies should take advantage of opportunities to promote integration of primary care and public health (eurekalert.org)

American Hospital Association Resource Center Blog

” . . . it is no longer sufficient to expect that reforms in the medical care delivery system (for example, changes in payment, access and quality) alone will improve the public’s health.”

The Institute of Medicine has issued the third and final report of a series on public health that focuses on how altering the fundamental physical and social environment will lead to improved health in the general population, an essential requirement of any effective reform of the system that delivers health care services.

For the Public’s Health: Investing in a Healthier Future addresses its thesis in four chapter:

• Introduction and Context
• Reforming Public Health and Its Financing
• Informing Investment in Health
• Funding Sources and Structures to Build Public Health

The committee responsible for the report also propose ten recommendations, among which are the following:

• Greater legislative/regulatory flexibility in the allocation of funds by state and local health agencies in pursuit of public health…

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