[News release] ​ Workplace Lifestyle Intervention Program Improves Health, Reduces Diabetes and Heart Disease Risks

In the past I’ve posted items that argue against workplace health programs. Perhaps some programs are better than others.

From the 6 March 2015 University of Pittsburg news release

A healthy lifestyle intervention program administered at the workplace and developed by the University of Pittsburgh Graduate School of Public Healthsignificantly reduces risk factors for diabetes and heart disease, according to a study reported in the March issue of the Journal of Occupational and Environmental Medicine.

The program was well-received by participants at Bayer Corp., who lost weight and increased the amount of physical activity they got each day, when compared with a control group in the study, which was funded by the National Institutes of Health.

“Health care expenditures associated with diabetes are spiraling, causing widespread concern, particularly for employers who worry about employee health and productivity,” said lead author M. Kaye Kramer, Dr.P.H., assistant professor in Pitt Public Health’sDepartment of Epidemiology and director of the school’s Diabetes Prevention Support Center. “This leads to an interest in workplace health promotion; however, there are very few evidence-based programs that actually demonstrate improvement in employee health. This study found that our program not only improves health, but also that employees really like it.”

This demonstration program is based on the U.S. Diabetes Prevention Program (DPP), a national study that found people at risk for diabetes who lost a modest amount of weight through diet and exercise sharply reduced their chances of developing diabetes, outperforming people who took a diabetes drug instead.

[Journal article] What the Agency for Healthcare Research and Quality Forgets to Tell Americans about How to Protect Their Sexual and Reproductive Health

What the Agency for Healthcare Research and Quality Forgets to Tell Americans about How to Protect Their Sexual and Reproductive Health 

From the January/February 2015 journal article abstract

If there is one thing that health care experts seem to agree on, it is the importance of preventive care. Anything that can help the American public to do a better job of understanding, accessing, and affording effective preventive care and thereby helping them to avoid potential threats to their health should be indisputably a good thing for individuals, families, and society.

Recommendations for the public about what preventive care services an individual might need at different points in his or her life can be one important tool in this tool box, and that goes double for recommendations that speak with the imprimatur of the U.S. Department of Health and Human Services (DHHS). So, a series of fact sheets on “staying healthy” from the Agency for Healthcare Research and Quality (AHRQ)—a branch of DHHS devoted to evidence-based improvements to the provision of U.S. health care—should be a welcome and valued resource (Agency for Healthcare Research and Quality (AHRQ), 2014a, Agency for Healthcare Research and Quality (AHRQ), 2014b).

In this light, it is disappointing to find the AHRQ fact sheets falling short of the mark in some critical ways related to their recommendations on sexual and reproductive health care. The four fact sheets—for women of all ages, women at age 50 and older, men of all ages, and men at age 50 and older—contain a wealth of good advice about screenings and preventive medicine that a patient might need. However, they leave out many effective sexual and reproductive health-related preventive services—perhaps most notably any mention of contraceptive services and supplies—that have been endorsed by other agencies in the DHHS and by the medical establishment more broadly, and that have been promoted through the Affordable Care Act’s (ACA) requirements for private health plans to cover preventive services without patient out-of-pocket costs (HealthCare.gov, 2014, Sonfield, 2012). The AHRQ fact sheets compound those oversights by seeming to imply that they embody the sum total of DHHS’s preventive care recommendations, when in reality they seem to be based almost exclusively on the recommendations of a single body, the U.S. Preventive Services Task Force.

Full text of the article here

Policy Changes For A Healthier America

 

From the 30 January 2013 article at Medical News Today

Some key policy changes that need to be made in the United States in order to prevent illness and improve the health of millions of Americans have just been outlined in the Trust for America’s Health (TFAH) latest Healthier Americareport.*** 

The report includes a range of suggestions that focus on the prevention of chronic diseases, which currently affect more than half of the U.S. population. This would also help address the health problems facing today’s youth who are set to be the first generation that are less healthy than their parents. …

…

The recommendations involve some new and innovative approaches:

• Implementing a series of foundational capabilities to improve the country’s health system as well as restructuring public health programs with sustained funding.
• Establishing partnerships with nonprofit hospitals to develop new community benefit programs and expand support for prevention.
• Encourage that insurance providers compensate for all types of prevention strategies
• Ensuring that the Prevention and Public Health Fund continues and improve awareness of the Community Transformation Grant program.
• Maintain workplace wellness programs with employers as well as local and state governments.

 

…

The report also includes information about recommendations that are already in action:

• The Accountable Care Community (ACC) brought more than 70 different partners to help patients with type 2 diabetes in and out of the doctor’s office. The ACC managed to reduce the cost of care by more than 10 percent per month for patients with type 2 diabetes – meaning savings of around $3,185 per person yearly.
• The Boston Children’s Hospital implemented The Community Asthma Initiative (CAI) with the purpose of supporting children with asthma in the Boston area. The initiative helped reduce hospital admissions due to asthma-related causes by around 80 percent as well as reducing emergency visits due to asthma by 60 percent.

The report concludes that there are 10 main public health issues that need addressing:

• obesity
• tobacco use
• healthy aging
• improving the health of minorities
• healthy babies
• environment health threats
• injury prevention
• controlling infectious diseases
• food safety
• bioterrorism

Read the entire article here

 

***The report summary and link to the full text of the report may be found here

 

 

Related articles

• Prevention urged to avoid a national health catastrophe (bizbeatblog.dallasnews.com)
• New Report from HSC and Trust for America’s Health Calls for Federal Action to Close Achievement Gap by Addressing School Health (healthyschoolscampaign.typepad.com)
• Comment: Take prevention seriously, make it a priority (timescolonist.com)
• Insight: Think preventive medicine will save money? Think again. (greatriversofhope.wordpress.com)
• The Seven States Least Prepared for Disaster (247wallst.com)
• Hawaii Rises to Second Healthiest State in Nation (damontucker.com)
• “Walk Across Texas” promotes healthier living (victoriaadvocate.com)
• National Shopping Program Aims To Support A Healthier Hispanic Community (paramuspost.com)
• Wendell Potter: Getting Young People to Work Against Their Own Best Interests: Here’s How It’s Done (huffingtonpost.com)

 

Let’s solve our most pressing healthcare problems first

From the 24 January 2013 post at KevinMD.com

“He’s dead, Jim.”

So here’s my beef. At the recent Forbes Healthcare Summit  there was a lot of focus on speakers and vendors offering very cool new tech, from future “Tricorders” that can diagnose multiple diseases, is non-invasive, and hand-held; personal genomics, where data from your own genome is cheap and easy to get and can be integrated with clinical knowledge to produce better care; targeted therapies for various diseases, using the specific biology of a patient and her disease to design a treatment.

All of these are awesome, but really have little impact on our most pressing healthcare problems.

In the U.S., we manage to deliver a triple-whammy: health care that is less effective than in other nations, is only available to limited numbers of people, and costs a ton. There are a number of factors that go into this, most of which are historico-cultural.

The article goes on to say how folks are marginalized through being unemployed, falling through cracks (as being poor and single), profit driven health care facilities, lack of data sharing, and more.

 

 

Read the entire article here

Related articles

• Health plans need to take more responsibility for rising costs (kevinmd.com)
• The critical factors driving up American health costs (kevinmd.com)
• Can Oregon save American health care? (washingtonpost.com)
• Mobile health technology adoption depends on insurers (kevinmd.com)

 

More than 16 million people with Medicare get free preventive services in 2012 Affordable Care Act made many preventive services no cost to beneficiaries (with link to a planning guide)

Affordable Care Act made many preventive services no cost to beneficiaries

From the 20 July 2012 article at the US Dept of Health and Human Services

The Affordable Care Act – the new health care law – helped over 16 million people with original Medicare get at least one preventive service at no cost to them during the first six months of 2012, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today.  This includes 1.35 million who have taken advantage of the Annual Wellness Visit provided by the Affordable Care Act.  In 2011, 32.5 million people in Medicare received one or more preventive benefits free of charge.

“Millions of Americans are getting cancer screenings, mammograms and other preventive services for free thanks to the health care law,” said Secretary Sebelius.  “These new benefits, made possible through the health care law, are helping people stay healthy by giving them the tools they need to prevent health problems before they happen.”

Prior to 2011, people with Medicare faced cost-sharing for many preventive benefits such as cancer screenings.  Through the Affordable Care Act, preventive benefits are offered free of charge to beneficiaries, with no deductible or co-pay, so that cost is no longer a barrier for seniors who want to stay healthy and treat problems early.

The law also added an important new service for people with Medicare — an Annual Wellness Visit with the doctor of their choice— at no cost to beneficiaries.

For more information on Medicare-covered preventive services, please visit: http://www.healthcare.gov/law/features/65-older/medicare-preventive-services/index.html

To learn what screenings, vaccinations and other preventive services doctors recommend for you and those you care about, please visit the myhealthfinder tool at www.healthfinder.gov.

Related articles

• Half on Medicare in AZ use free preventive care (Rim Country Gazette)
• Pennsylvania seniors with Medicare receive free screenings (Times-Tribune)
• Michigan seniors strive to stay healthy (TheDailyReporter)

• Ask Medicare Helps Caregivers Plan for the Future (Center for Medicare and Medicaid Services)

  Baltimore, MD, June 28, 2012 /PRNewswire/ — Now is an ideal time for caregivers to get organized, manage personal finances and plan for the future. Effective long-term planning can help bring peace of mind and is particularly important for the nation’s growing number of caregivers who must manage their own affairs while attending to the health and well-being of another. Nearly 66 million U.S. residents¹ provide care for a chronically ill, disabled or aging family member or friend. This can involve:

  • Setting up doctor appointments for the many free, preventive services available to Medicare beneficiaries,
  • Reviewing drug plan coverage,
  • Planning for changes in in-home care needs, or
  • Preparing for a transition from the home to an assisted living or nursing home facility.

  The Centers for Medicare and Medicaid Services initiative, Ask Medicare, can help caregivers plan by offering a wealth of consumer-focused information, including personal stories from other caregivers on overcoming common challenges, a free e-newsletter, and decision-making tools addressing a range of health care issues. The “How Can you Plan for the Future?” checklist provides planning ideas.

AHRQ’s Health Care Innovations Exchange Focuses on Clinical-Community Linkages to Improve Chronic Disease Car

AHRQ’s Health Care Innovations Exchange Focuses on Clinical-Community Linkages to Improve Chronic Disease Care

From a recent email update rec’d from AHRQ (US Agency for Healthcare Research and Quality)

The July 3 issue of AHRQ’s Health Care Innovations Exchange features two profiles of partnerships between clinical practices and community organizations that leverage health provider teams and lay health advisors to improve the management of chronic diseases. One profile describes a public-private initiative that worked with community health teams to improve the delivery of preventive, health maintenance, and chronic care services in Vermont. The pilot program included incentive payments to providers who met National Committee for Quality Assurance-determined care standards, access to an insurer-funded team of community-based health providers, health information incorporated into a Web-based clinical tracking system, and interfaces with other State care coordination initiatives. Over a 4-year period, the pilot program experienced a 6 percent decrease in inpatient admissions and a 10 percent decrease in emergency department visits among participating practices. Select to read more profiles related to clinical-community linkages, including innovations and tools, on the Health Care Innovations Exchange Web site, which contains more than 700 searchable innovations and 1,500 QualityTools.

Related articles

• AHRQ Implementation Toolsets for E-Prescribing (medicineandtechnology.com)
• 11 Chronic Disease Technologies to Watch (thielst.typepad.com)
• Involving eHealth: How Health Care Leaders May Envelop Chronic Care Management Strategies with Health Information Exchange Directives (silverevolution.wordpress.com)
• Tools Help Foster Communication Between Patients and Clinicians (thielst.typepad.com)

Highest-Value Preventive Services Save Billions if Applied to 90 Percent of U.S. Population

From the 12 June 2012 article at the Robert Woods Foundation Web site

Identifying the highest-value clinical and community preventive services

Published: Jun 12, 2012

• Read the Program Results Report

Dates of Project: 2006–2012

Field of Work: Identifying high-value evidence-based clinical and community preventive services.

Problem Synopsis: The health impact and cost-effectiveness of clinical preventive services such as smoking cessation or breast cancer screening needs to be examined and re-examined as more and better data becomes available, and as analytical tools improve. Disparities in the use of services also need to be examined and documented.

Similarly, preventive interventions to improve health at the community level such as seat belt laws, need to be examined for their health and economic impact.

Synopsis of the Work: A research team at the Partnership for Prevention:

• Updated rankings of clinical preventive services recommended by the U.S. Preventive Services Task Force
• Estimated the health and economic benefits for the U.S. population and selected subpopulations of increasing their use
• Quantified disparities in their provision
• Developed and tested methods for estimating the health and economic impact of interventions to improve health at the community level that were recommended by the Centers for Disease Control and Prevention

Key Results and Findings:

• The research team updated the rankings of clinical preventive services recommended by the CDC. When published in 2012, the analysis will show that highly rated services—including childhood immunizations, tobacco cessation counseling, and discussing daily aspirin use to prevent heart disease—continue to be a good value because of their health impact and cost-effectiveness.
• The team found that providing 90 percent of the U.S. population with three clinical preventive services—tobacco cessation screening and assistance; discussing daily aspirin use; and alcohol screening with brief counseling—would generate an estimated net savings of more than $1 billion each, per year. In addition, these three services plus colorectal cancer screening each would prevent the loss of more than 100,000 years of life, a year.
• The team found troubling disparities, and specific opportunities for improvement, in the use of clinical preventive services among racial and ethnic populations.
• The team created analytic tools to assess the health and economic benefits of interventions to improve health and prevent disease at the community level, and used them to assess interventions to reduce tobacco use and increase physical activity.

Related articles

• Health of Americans a Mixed Bag: CDC Report (news.health.com)

• Journals call for integration between public health and primary care (PublicHealthNewsWire)

• Can Health Apps Find Users Who Are, Or Are About To Be, Really Sick? (bostinno.com)
• Key Preventive Health Services – Only Half Of U.S Adults Benefitted Before 2010 (medicalnewstoday.com)
• Many Lacked Preventive Care Before Health Reform Law: U.S. Report (news.health.com)
• No Preventive Care For 1 In 2 U.S. Adults (personalliberty.com)
• A population health approach to wellness (kevinmd.com)
• 90-95% of Cancers are Preventable (anoil4everyailment.com)