The Urban Institute recently released a report documenting the potential savings available in prevention of avoidable chronic illness. The high and rising prevalence of chronic disease represents a substantial burden on the medical care system and a major cost for society, leaving aside its toll on individuals. The burden presents as rising rates of obesity, increased prevalence of diabetes, greater incidence of disability, and the rising cost of medical care and other disease-related costs. The Congressional Budget Office (CBO) reports that medical spending on obese adults is 38 percent higher than on their normal-weight counterparts. The cost of cardiovascular disease in medical treatment and lost productivity has been estimated at $400 billion per year, of which about one-quarter comes from lost productivity. The California Public Employees' Retirement System (CalPERS) health program covers...

The Commonwealth Fund recently published a paper in Medscape Public Health regarding preventive health services under the Affordable Care Act (ACA). The law has already extended coverage to dependents through age 26. By 2014, Medicaid will expand to cover most low-income adults and the exchanges will extend insurance to many small business and individuals. This eminent expansion of health insurance coverage will greatly increase in the use of preventive services in the United States. ACA provisions also eliminate cost sharing associated with the provision of preventive services, which will also likely impact use. Finally, the movement toward medical homes will also augment the use of preventive services. The paper discusses these relationships in the context of delivery system reforms.

According to a report released by the Government Accountability Office, Medicare coverage of preventive services is not consistently aligned with recommendations by the U.S. Preventive Services Task Force. Preventive care services have the potential to improve health outcomes and lower health care expenditures. Thr report examines (1) whether preventive service use by Medicare fee-for-service (FFS) beneficiaries aligns with recommendations from the U.S. Preventive Services Task Force and the Advisory Committee on Immunization Practices (ACIP), (2) use of the Welcome to Medicare (WTM) exam and its association with use of preventive services, (3) preventive service use in Medicare Advantage (MA) relative to FFS, and (4) service use among MA health maintenance organizations (HMO) and efforts by high-performing HMOs to encourage preventive care. To do this, GAO selected eight preventive services that had Task Force or ACIP guidelines for the general Medicare population. GAO analyzed the most recently available data from Medicare claims, a beneficiary survey, and MA plan ratings. GAO also interviewed representatives of selected HMOs. GAO recommends that Congress consider...

The Affordable Care Act (ACA) created the Prevention and Public Health Fund, a 10-year, $15 billion commitment to support programs, medical screenings, and research related to public health and prevention. This national commitment to investment in preventing disease before it occurs is in line with evidence from a variety of recent reports and studies indicating that strategic investments in proven, community-based prevention programs could result in significant U.S. health care cost savings and overall economic cost savings. The Robert Wood Johnson Brief, "Return Investments in Public Health: A Summary of Groundbreaking Research Studies," summarizes the findings and recommendations from four major studies released between 2008 and 2011.

The Institute of Medicine (IOM) of the National Academy of Sciences has released a new report that recommends 8 preventive services for women, including birth control, be covered by insurance companies with no cost-sharing, including copayment. Services include screening and counseling for certain sexually transmitted infections, screening for gestational diabetes, and among others, counseling and contraception to prevent unintended pregnancies. The report, "Clinical Preventive Services for Women: Closing the Gaps," was produced by the IOM at the request of the U.S. Department of Health and Human Serivces (HHS), who will have final say on which of the 8 services are included in the final regulation.