One Day, Two Announcements: A Growing Recognition of the Power of Prevention

Last week was a big week for the growing recognition that preventative medicine is the next, biggest frontier in health care.

First, at the White House Conference on Aging regional forum in Boston, HHS Secretary Sylvia Burwell announced that the Centers for Medicare and Medicaid Services (CMS) will soon begin the largest test of value-based prevention payment it has ever conducted, the Million Hearts Cardiovascular Disease (CVD) Risk Reduction Model.

Second, the Bipartisan Policy Center (BPC) released a set of recommendations, titled A Prevention Prescription for Improving Health and Health Care in America, to address the challenge of embracing prevention-oriented strategies in the American health care system. Alice Rivlin, Senior Advisor at BPC and the former director of the Office of Management & Budget, stated the challenge to prevention at the report’s release: “Health care providers are not trained to keep people out of the doctor’s office – right now, they’re trained to cure disease.”

We’re ecstatic that outlook is starting to change, and that providers, payers, — and yes, even the government — are recognizing that an ounce of prevention now is vastly superior to a pound of treatment later. A focus on prevention helps individuals lead healthier lives and lowers health care costs for health plans, employers, and the rest of the system at large. Again, the Task Force put it succinctly: Prevention Delivers Value.

The two-part framework released by the Bipartisan Policy Center’s Prevention Task Force yesterday focuses on building the evidence base for prevention and near-term opportunities to embed its value into health care delivery system reforms. We’re excited to see their recommendations dovetail so nicely with something that’s been at the heart of Omada from the start: building evidence-based programs and submitting their outcomes to peer-reviewed, clinical scrutiny.

CMS’ announcement of the new Million Hearts Cardiovascular Disease (CVD) Risk Reduction Model is just as exciting, if not more so. The initiative will test a system of paying providers for reducing the long-term risk of their patients developing cardiovascular disease. Providers who participate in the program will work with Medicare beneficiaries to determine their individual risk for a heart attack or stroke in the next ten years, identify the best approach to reduce their risk, and establish a health care plan to target their specific risk factors. Later, the providers will be reimbursed for reducing the risk of heart attack or stroke among their high-risk patients. Earlier this year, we expanded our Prevent curriculum to help participants lower exactly this type of cardiovascular disease risk.

Dr. Darshak Shanghavi, the Director of the CMS Preventative and Population Health Care Model Group, said it best at yesterday’s panel: “For too long in medicine, we’ve known the cost of almost everything – but the value of almost nothing.”

Finally, as payers and providers recognize the value of prevention, that’s changing.