Affordable Care Act: Laying the Foundation for Prevention

Chronic diseases – such as heart disease, cancer, stroke, and diabetes – are responsible for 7 of 10 deaths among Americans each year and account for 75% of the nation’s health spending. Often due to economic, social, and physical factors, too many Americans engage in behaviors – such as tobacco use, poor diet, physical inactivity, and alcohol abuse—that lead to poor health. 

President Obama believes a focus on prevention will offer our nation the opportunity to not only improve the health of Americans but also control health care spending.  By concentrating on the underlying drivers of chronic disease, the Affordable Care Act (ACA) helps us move from today’s sick-care system to a true “health care” system that encourages health and well-being.

The ACA creates a National Prevention, Health Promotion, and Public Health Council, composed of senior officials across the government, to elevate and coordinate prevention activities and design a focused strategy across Departments to promote the nation’s health. On June 10, the President signed an Executive Order creating the National Prevention Council.

In addition, the Affordable Care Act creates a new Prevention and Public Health Fund designed to expand and sustain the necessary infrastructure to prevent disease, detect it early, and manage conditions before they become severe.  This new initiative will increase the national investment in prevention and public health, improve health, and enhance health care quality.

Earlier this week, President Obama announced plans to spend $250 million from the Fund to support the training and development of primary care professionals who frequently deliver preventive services to patients.  Today, Health and Human Services Secretary Kathleen Sebelius announced the allocation of another $250 million in federal fiscal year 2010 for prevention from the new Fund. These new funds are dedicated to four critical priorities: 

Community and Clinical Prevention ($126 million)

The initiative supports prevention activities that we know will work to reduce health care costs and improve the promotion of health and wellness.

• Putting Prevention to Work ($74 million).  Support federal, state and community initiatives touse evidence-based interventions to address tobacco control, obesity prevention, HIV-related health disparities, and better nutrition and physical activity. 
• Primary and Behavioral Health Integration ($20 million).  Assist communities with the coordination and integration of primary care services into publicly-funded community mental health and other community-based behavioral health settings. 
• Obesity Prevention and Fitness ($16 million).  Advance activities to improve nutrition and increase physical activity to promote healthy lifestyles and reduce obesity related conditions and costs. These activities will support the First Lady’s “Let’s Move!” initiative and help implement recommendations of the President’s Childhood Obesity Task Force.
• Tobacco Cessation ($16 million). Implement anti-tobacco media campaigns showing the negative health consequences of tobacco use, telephone-based tobacco cessation services, and outreach programs targeting vulnerable populations. 

Public Health Infrastructure ($70 million)

The allocation strengthens state and local capacity to prepare health departments to meet 21^st century challenges. 

• Public Health Infrastructure ($50 million).  Support state, local, and tribal public health infrastructure to advance health promotion and disease prevention through improved information technology, workforce training, and regulation and policy development.
• Epidemiology and Laboratory Capacity Grants ($20 million). Build state and local capacity to prevent, detect, and respond to infectious disease outbreaks. 

Research and Tracking ($31 million)

The initiative supports the Affordable Care Act’s expansion of coverage for community and clinical preventive services by increasing resources for guidance and evaluation of preventive services. 

• Surveillance ($21 million).  Fund data collection and analysis to measure the impact of health reform and support strategic planning.
• Community Preventive Services Task Force ($5 million).  Strengthen CDC’s Community Guide by supporting the Task Force on Community Preventive Services’ efforts to identify and disseminate additional evidence-based recommendations on important public health decisions to inform policymakers, practitioners, and other decision makers.
• Clinical Preventive Services Task Force ($5 million). Expand the development of recommendations for clinical preventive services, with enhanced transparency and public involvement in the processes of the Task Force.

Public Health Training ($23 million)

These funds support the training of existing and next generation public health professionals.

• Public Health Workforce ($8 million).  Expand CDC public health workforce programs to increase the number of fellows trained and placed in public health positions.
• Public Health Training Centers ($15 million).  Support training of public health providers to advance preventive medicine, health promotion and disease prevention, and improve the access and quality of health services in medically underserved communities.