In his address to the nation on Tuesday night, President Obama said that the best way for the U.S. to "bend the curve" on the national deficit is through reducing health care costs, citing prevention as one of the ways to achieve that goal.
Crafting effective solutions to increases in health expenditures requires a clear understanding of where we spend our health care dollar and the factors accounting for rising spending. Chronic diseases have played a major role in the rise of U.S. health care costs. A multifaceted approach—reaching people where they live, play, work and go to school—will be critical to successful treatment, reduction and prevention of these conditions, and the key to successful programs is evidence-based design and delivery.
As the President and Congress form a health reform package, they should look at best practices to identify key design features of successful programs. Based on rigorous assessments of such programs, these features include:
• Financial incentives to participate in health risk appraisals;
• Reducing or eliminating cost sharing for preventive services;
• Carefully crafted individualized care plans with incentives to meet key objectives;
• The availability of health care personnel at the workplace; and
• Leadership from the top.
These types of well-designed programs, coupled with the broader use of primary prevention efforts in schools, workplaces, and communities and enhanced prevention in clinical settings, can reduce the growth in chronic disease and create substantial opportunities for cost savings.