Tim_HeadshotAccording to Dr. Darshak Sanghavi, Director of the Preventive and Population Health Models Group of the Center for Medicare and Medicaid Innovation, we’re all living one long episode of the Bachelor, at least, as the show relates to how we pay for medical care in the United States.

The premise of the Bachelor, he said, during a Bipartisan Policy Center (BPC) panel discussion last Thursday, isn’t about cultivating durable, fruitful marriages, even though that would be a reasonable long-term endpoint of the show. Instead, the popular reality program thrives on dramatic narratives that attract as many weeknight viewers as possible. Similarly, within medical care, he said, we want to prevent acute or chronic medical conditions, like heart attacks. But the system also incentivizes volume, box checking and short-term wins, and loses focus on the endpoint.

This issue of payment as a barrier to integrating prevention into health care was one of many points of focus during the discussion, which examined a BPC Prevention Task Force’s report, “A Prevention Prescription for Improving Health and Health Care in America.”

“We know the price of everything, and we don’t know the value of anything in the ways that we pay for health care,” Sanghavi said.

In addition to payment, the task force found that there is inadequate coordination between community and clinic to assess needs and evaluate and implement prevention interventions.

“Prevention is a powerful and underused tool in our health system,” said Lisel Loy, Director of the BPC Prevention Initiative, who noted that prevention isn’t just clinical interventions like mammograms and immunizations, but include community-based interventions, like weight-loss programs and activities. “Currently, our system undervalues prevention; we lack incentives to invest in it and rarely reimburse for it, and we lack sufficient information on what works at scale, particularly on the costs and cost effectiveness of those interventions.”

Loy moderated the discussion and opened it up by acknowledging the esteemed Task Force members who focused the project to answer the question, “how can our health system better value prevention to help us achieve our shared goals of better health and lower health care costs?”

The task force, which was comprised of William H. Dietz, MD, PhD; Ron Goetzel, PhD; Jeff Levi, PhD; Matt Longjohn, PhD, MPH; Tracy Orleans, PhD; and Murray Ross, PhD, organized their recommendations into in two buckets: 1) building the evidence on the value of prevention, and 2) creating opportunities for integrating prevention into the broader heath care delivery system by moving from volume to value-based care and cultivating relationships with the community.

Among the task force’s recommendations were for the federal government and other public and private funders to require economic analyses on interventions to determine their cost-benefit and effects on health, as well as promoting better engagement between communities, public health officials, hospitals and other stakeholders.

The briefing also included opening remarks from Dr. Alice Rivlin, Senior Advisor of the BPC Prevention Task Force, and Dietz, Levi and BPC Senior Vice President William Hoagland participated in the panel discussion.

Read more about the report here.

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