Principles for Meaningful Health Reform

Americans have made it clear that health reform is the domestic issue that they want Congress and the Obama Administration to make a top priority.

In this turbulent economy, no single policy opportunity will have as dramatic an impact as effectively addressing the growing crisis of chronic disease.

The “unhealthy truth” is that chronic disease—long-lasting, often preventable and treatable illnesses such as arthritis, asthma, diabetes, heart disease, cancer, and depression—is the #1 cause of death and disability in the U.S. Chronic disease is also the #1 driver of rising health care costs, accounting for more than 75 percent of all money spent on health care. The avoidable physical and financial burden chronic disease puts on individuals drains the economy overall, and hurts our ability to compete in the global economic environment. By investing in the health of all Americans, by both preventing illness and managing disease to avoid complications, we can lower disability, boost productivity, and improve the overall health of our economy.

Americans can no longer afford a “sick” care system. We deserve a health care system that lives up to its name. We deserve a health care system that encourages and incentivizes all of us—individuals, providers, and payers alike—to preserve and enhance health – by both preventing disease before it occurs when possible and by catching disease early and managing it aggressively to prevent disability and early death. We cannot afford to lose more lives to preventable or undermanaged chronic disease.

Assuring access to high quality, affordable health care coverage is important. Preventing and managing chronic diseases effectively depends upon people having access to preventive health care services, diagnostic services that detect chronic disease early, and coordinated care to help us manage chronic illness once detected. Coverage alone, however, will not address the growing burden of chronic disease. More comprehensive health reform is needed to effectively address the prevention and control of chronic disease directly.

To improve Americans’ ability to fight chronic disease and control costs in the U.S. health care system, we encourage Congress and the Obama Administration to advance comprehensive health reform proposals that: s Realign Health System Incentives to Prioritize Prevention and Chronic Care Management. Modernize the health care infrastructure to align incentives to encourage and empower health care payers, employers, providers, and individuals to better prevent, detect, and treat chronic diseases—both physical and mental—before they become an acute problem.

We can start by: s Building capacity in the primary care and public health workforce to support health promotion and the prevention, detection, and treatment of chronic diseases. s Facilitating and rewarding the provision of quality preventive care and coordinated care management for those with chronic conditions. s Encouraging and empowering Americans to proactively improve their health through education and targeted incentives that support better self-management and adherence to preventive care and treatment recommendations. s Supporting those with family caregiving responsibilities, improving the quality of acute, long-term and end of life care, and strengthening long-term care options. s Encourage Continuous Improvements in Health Care Delivery and Quality of Care. Center health care reform efforts on generating continuous improvements in health care quality and outcomes, and innovations in clinical practices and technology, so Americans have the best chance of fighting chronic diseases today and tomorrow.

We can start by: s Rewarding evidence-based clinical practice to promote the delivery of high-quality care that improves health outcomes. s Supporting greater emphasis on providing quality care to chronically ill patients in medical education programs. s Funding and supporting research and innovation that increases our ability to readily prevent, aggressively manage, and ultimately cure costly chronic diseases. s Accelerating improvements in the quality, accessibility, and interoperability of health information technology (HIT) throughout the health care system that facilitate care coordination, enhance the quality of care provided, assist patients in following recommended treatment, and improve health outcomes. s Managing transitions between care settings and providers to promote care coordination, avoid gaps in care, and improve health outcomes. s Eliminate health disparities. Ensure that every American has access to quality health care, regardless of geographic location, race, age, gender or disability.

We can start by: s Improving cultural competency in the provision of care and promoting health literacy so that all of us can find, understand, and evaluate health information to make informed health decisions. s Investing in safety net health systems which provide high-quality care to vulnerable patients who suffer disproportionately from chronic illness. s Investing in education for underrepresented minorities in health professional schools. s Funding research into the causes of and solutions to health disparities. s Employing community-based approaches to addressing health disparities. s Focus on Promoting Prevention Across Generations. Younger Americans are suffering from preventable chronic diseases at higher rates than their parents did at the same age. Although improving the health status of the current and future workforce in America is vital to the economy, Americans across generations — children, young adults, baby boomers and the elderly — can benefit substantially from preventive care and better management of chronic disease.

We can start by: s Promoting healthy lifestyles, physical activity, and chronic disease promotion and management in every community across all settings. s Increasing individual awareness of personal health status and empowering individuals to improve their health status and reduce risks by following preventive care and treatment recommendations. s Supporting models of population health improvement shown to improve health among Americans of all backgrounds and situations. s Building capacity in the primary care and public health workforce to promote wellness and help assure access to preventive care and chronic care management services. s Translate Knowledge Into Action. While there is still much to be learned about effectively promoting wellness and improving disease prevention and management, we must both act on the knowledge we already have about what works, and generate new evidence about effective practices in disease prevention and management.

We can start by: s Accelerating the diffusion and adoption of improvements in clinical care and other research findings into clinical practice. s Expanding public support for research to increase our knowledge about successful approaches to chronic disease prevention and management across conditions, settings, and populations. s Capturing and using data to define and measure improvements in quality of services provided and health outcomes achieved. s Collecting and sharing best practices in population health improvement across populations, settings, health risks, and conditions.

Only by addressing the crisis of chronic disease can we make meaningful changes and achieve true health reform. These common-sense principles for health reform describe the changes needed to inspire and sustain a culture of wellness in America, to improve the health status of all Americans, and to alleviate the burdens of avoidable costs, preventable disability, and premature death from chronic disease.