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Straight Talk for Seniors®: The Prevention and Public Health Fund

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We’ve all heard the saying: “An ounce of prevention is worth a pound of cure.”

Doctors know—and the research shows—that preventing disease and injury costs less and works better when it comes to improving people’s health.

But in the U.S., our health care system focuses much more on treating problems after they occur, instead of preventing them in the first place.

Since 2010, the Prevention and Public Health Fund (PPHF) has been working to change that. Created by the Affordable Care Act (ACA), the PPHF is the nation’s largest single investment in prevention.

Why Prevention Matters

Today, 40% of premature deaths are linked to smoking, poor diet, lack of physical activity, and other unhealthy behaviors. Yet less than 5% of our nation’s health care spending goes to public health.

The PPHF is a coordinated, accountable approach to improving people’s health through prevention. It supports and evaluates evidence-based programs that have been proven to help people stop smoking, prevent injuries, reduce obesity, manage chronic diseases, receive lifesaving vaccines, and more.

Two PPHF provisions are specifically targeted to help older Americans and adults with disabilities.

Falls Prevention

  • Problem: Every 19 minutes, an older adult dies from a fall, and every 11 seconds an older adult is treated in an emergency room for a fall-related injury. Medicare spends an estimated $31 billion every year just to treat falls-related injuries. Without any change, that cost is projected to reach $52 billion in 2020.
  • How the PPHF Helps: The PPHF provides funding for evidence-based falls prevention programs in 30 states and communities. These low-cost programs empower individuals to reduce their falls risk by adopting healthy behaviors, such as regular physical activity to improve balance and strength.
  • Who Benefits: Since 2014, more than 30,000 older Americans and adults with disabilities have participated in PPHF-funded falls prevention programs. Randomized controlled trials have shown that these programs can reduce falls rates by up to 55% and reduce annual medical costs by up to $938 per person.

Chronic Disease Self-Management Education (CDSME)

  • Problem: Chronic diseases such as heart disease, cancer, stroke, and diabetes are responsible for 7 in 10 American deaths each year and account for 75% of our nation’s health care spending. Over 90% of older adults have at least one chronic condition and two-thirds have two or more.
  • How the PPHF Helps: The PPHF funds evidence-based CDSME programs in 30 states and communities. These low-cost programs help individuals with chronic diseases take personal responsibility to better manage and control their conditions. Participants learn healthy behaviors that help reduce their visits to the hospital or emergency room.
  • Who Benefits: Since 2012, 170,000 older adults have participated in PPHF-funded CDSME programs. Research has shown that CDSME helps participants improve their psychological well-being, increase physical activity, reduce fatigue and social limitations, and communicate better with their health care providers. A 2013 study supported by the U.S. Administration on Aging found that if CDSME was provided to just 10% of Americans with chronic conditions, the nation could save $6.6 billion.

Prevention Under Threat

Despite positive results, the PPHF is likely to be included in the ACA repeal legislation expected in the first 100 days of the new Administration—with no specific plans to replace it. The ACA repeal bill passed in 2015 eliminated the PPHF entirely.

Unlike other provisions of the ACA repeal bill—which delayed repeal for two years to provide time to pass a replacement—no such delay was provided for the PPHF.

We believe that any PPHF repeal effort must include a specific plan to replace it. Prevention programs save money—and help Americans stay healthy and independent longer.

Do your members of Congress support prevention programs? If so, please tell us their names, so we can encourage them to protect the PPHF.

Do you think prevention programs are worth protecting? Tell us why in the comments below.

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Howard Bedlin

About Howard Bedlin

Howard Bedlin is NCOA's Vice President of Public Policy and Advocacy. He is responsible for all of NCOA’s federal and state legislative advocacy efforts on issues and programs of concern to older adults, which include the Older Americans Act, Medicare, Medicaid, long-term care, income security, and community services programs.