Trust for America's Health offers 38 recommendations for the U.S. healthcare system to shift from a system that focuses on treating the sick to a system that focuses more on preventing sickness and maintaining health in a new report, "A Healthier America 2013: Strategies to Move from Sick Care to Health Care in Four Years."
The recommendations are organized around two main goals: advancing the country's public health system and building partnerships within and outside the health field.
Here are Trust for America's recommendations, as outlined in the report.
Advancing the nation's public health system
1. Strengthen the role of health departments as the chief health strategist in communities.
2. Define, prioritize and fully fund a set of foundational capabilities for public health departments at all levels of government.
3. Prioritize accountability for achieving and maintaining foundational capabilities through accreditation and other mechanisms.
4. Integrate with healthcare providers to contain costs and improve health.
5. Partner with other sectors and members of the community to make healthier choices easier in our schools, workplaces and neighborhoods.
6. Develop a public health workforce to meet modern demands.
7. Use modern technology to improve the ability to identify top health problems in a community and determine their causes and cures.
8. Public health departments should only pay for direct services when they cannot be paid for by insurance.
9. Improve efficiencies of programs at the Center for Disease Control and Prevention through strategic realignments and integration.
10. Evaluate the possibility of increased integration and flexibility of CDC's grants to state and local health departments in exchange for increased accountability.
11. The Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration and CDC should become payors of last resort for direct services.
12. Consolidate federally supported public health surveillance systems.
13. Appoint an independent group of experts, such as by creating a committee at the Institute of Medicine, National Academy for Public Administration and/or think tank initiative, to evaluate possible ways to restructure public health agencies to improve and align functions and services.
14. Define a modern role for the Surgeon General.
15. Increase funding for public health at the federal, state and local levels.
16. Ensure all Americans are protected by a minimum set of public health services.
17. Explore new funding models to guarantee sufficient levels of funding to support basic capabilities.
18. Evaluate the possibility of a model of shared federal-state-local-tribal responsibility for delivering foundational capabilities and maintenance of programs and funding.
19. Examine a new model that increases flexibility for state and local health departments that demonstrate core capabilities.
Building partnerships within and outside the health field
20. The government and private insurers should implement policies and programs to increase utilization of preventive services, particularly among communities with under usage.
21. All insurers should eliminate co-pays for United States Preventive Services Task Force A and B services. In particular, Medicare and state Medicaid programs should meet, at the minimum, the requirements set by the Affordable Care Act for private insurers and self-insurers.
22. The Medicare program should ensure that all beneficiaries are aware of the increased coverage and elimination of most co-pays for preventive services in order to help encourage increased use of these services.
23. A mechanism must be created to review and reconcile inconsistencies in preventive services recommendations and benefit coverage to ensure full coverage of the most effective preventive services across all payors and protect population health in addition to individual benefit.
24. Expand Medicaid coverage of community prevention programs.
25. Use new Medicaid health homes to improve coordination of health and other services for low-income Americans.
26. Expand private insurance coverage of community prevention programs.
27. New health system approaches, including accountable care organizations and global health budgeting, must incorporate community prevention and public health to be successful in reaching goals to improve health and lower costs.
28. The Internal Revenue Service should take steps to ensure that non-profit hospitals maximize the advantages of the community benefit requirement.
29. Non-profit hospitals should use the new rules under the Patient Protection and Affordable Care Act to evaluate and reassess how they spend their community benefit resources.
30. Ensure full funding of the Prevention and Public Health Fund.
31. Increase the number of Community Transformation Grants so that all Americans benefit.
32. Fully implement the National Prevention Strategy Recommendations.
33. Facilitate partnerships to meet agencies' goals.
34. The federal government should implement a comprehensive, evidence-based wellness program for all federal employees so that all government workers have access to wellness programs.
35. Every state and local government should offer a comprehensive, evidence-based wellness program.
36. Providing wellness programs to teachers and other educators should be a high priority.
37. States should make wellness programs a key component of their health insurance exchanges.
38. Private employers — regardless of their size — should provide effective, evidence-based wellness opportunities for their employees.
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The recommendations are organized around two main goals: advancing the country's public health system and building partnerships within and outside the health field.
Here are Trust for America's recommendations, as outlined in the report.
Advancing the nation's public health system
1. Strengthen the role of health departments as the chief health strategist in communities.
2. Define, prioritize and fully fund a set of foundational capabilities for public health departments at all levels of government.
3. Prioritize accountability for achieving and maintaining foundational capabilities through accreditation and other mechanisms.
4. Integrate with healthcare providers to contain costs and improve health.
5. Partner with other sectors and members of the community to make healthier choices easier in our schools, workplaces and neighborhoods.
6. Develop a public health workforce to meet modern demands.
7. Use modern technology to improve the ability to identify top health problems in a community and determine their causes and cures.
8. Public health departments should only pay for direct services when they cannot be paid for by insurance.
9. Improve efficiencies of programs at the Center for Disease Control and Prevention through strategic realignments and integration.
10. Evaluate the possibility of increased integration and flexibility of CDC's grants to state and local health departments in exchange for increased accountability.
11. The Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration and CDC should become payors of last resort for direct services.
12. Consolidate federally supported public health surveillance systems.
13. Appoint an independent group of experts, such as by creating a committee at the Institute of Medicine, National Academy for Public Administration and/or think tank initiative, to evaluate possible ways to restructure public health agencies to improve and align functions and services.
14. Define a modern role for the Surgeon General.
15. Increase funding for public health at the federal, state and local levels.
16. Ensure all Americans are protected by a minimum set of public health services.
17. Explore new funding models to guarantee sufficient levels of funding to support basic capabilities.
18. Evaluate the possibility of a model of shared federal-state-local-tribal responsibility for delivering foundational capabilities and maintenance of programs and funding.
19. Examine a new model that increases flexibility for state and local health departments that demonstrate core capabilities.
Building partnerships within and outside the health field
20. The government and private insurers should implement policies and programs to increase utilization of preventive services, particularly among communities with under usage.
21. All insurers should eliminate co-pays for United States Preventive Services Task Force A and B services. In particular, Medicare and state Medicaid programs should meet, at the minimum, the requirements set by the Affordable Care Act for private insurers and self-insurers.
22. The Medicare program should ensure that all beneficiaries are aware of the increased coverage and elimination of most co-pays for preventive services in order to help encourage increased use of these services.
23. A mechanism must be created to review and reconcile inconsistencies in preventive services recommendations and benefit coverage to ensure full coverage of the most effective preventive services across all payors and protect population health in addition to individual benefit.
24. Expand Medicaid coverage of community prevention programs.
25. Use new Medicaid health homes to improve coordination of health and other services for low-income Americans.
26. Expand private insurance coverage of community prevention programs.
27. New health system approaches, including accountable care organizations and global health budgeting, must incorporate community prevention and public health to be successful in reaching goals to improve health and lower costs.
28. The Internal Revenue Service should take steps to ensure that non-profit hospitals maximize the advantages of the community benefit requirement.
29. Non-profit hospitals should use the new rules under the Patient Protection and Affordable Care Act to evaluate and reassess how they spend their community benefit resources.
30. Ensure full funding of the Prevention and Public Health Fund.
31. Increase the number of Community Transformation Grants so that all Americans benefit.
32. Fully implement the National Prevention Strategy Recommendations.
33. Facilitate partnerships to meet agencies' goals.
34. The federal government should implement a comprehensive, evidence-based wellness program for all federal employees so that all government workers have access to wellness programs.
35. Every state and local government should offer a comprehensive, evidence-based wellness program.
36. Providing wellness programs to teachers and other educators should be a high priority.
37. States should make wellness programs a key component of their health insurance exchanges.
38. Private employers — regardless of their size — should provide effective, evidence-based wellness opportunities for their employees.
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