What Is the Public-Private Bridge?
Written by Editor   
Tuesday, July 01, 2014 10:41 AM

Bridging the gap between the U.S. public health system and private healthcare is a key mandate of the Affordable Care Act (ACA) that has gone largely unrecognized.  Few so far have described the potential effects of the this mandate on prevention and public health. The public and private health sectors have operated with very little interaction for almost a century.  The ACA's Prevention and Public Health Fund, or Prevention Fund, aims to change that by calling for alignment, coordination, and integration between the two entities.

"Due to the Affordable Care Act, Medicare is now providing coverage for evidence-based preventive services with no copayments."  "We are testing new payment and service delivery models focused on prevention and population health."

Such collaborative care could be a "game-changer that improves the health of the U.S. population." Better integration may prove to be the most radical change through the Prevention Fund as it will allow public health systems to bill insurers for some services, such as immunization.Coordination between the two systems will mean that private clinical providers will be able to refer patients to community programs.  

In terms of alignment, the largest proportion of the fund will go toward programs that encourage the systems to focus on the same disease or risk factor. An example is Million Hearts, a HHS program which is intended to prevent 1 million heart attacks and strokes by 2017. As a first step, CMS will award 10 states $85 million in grants for the prevention of chronic diseases -- grants that will pay for weight reduction and smoking cessation programs as well as initiatives that target control of lipids and diabetes prevention. The CMS will also encourage Americans to take advantage of annual wellness visits at no cost. By leveraging the strengths of many federal, state and private partners to improve access to and quality of healthcare, the Million Hearts initiative will reach into every level of society.  "Improving prevention and care is the goal. We know the key steps needed to improve heart health … choices that will improve blood pressure and cholesterol levels." [1]  

The ultimate goal is to convert U.S. healthcare from a "sick care system," or one that centers on treatment, into a system that emphasizes prevention, early disease detection, and the promotion of healthy living.

Other ACA programs that will bolster the public-private care connection include community needs assessments by hospitals in order to maintain a nonprofit status, and implementation of the National Prevention Strategy [2]–a strategy of four priorities:

  • Healthy and safe community environments,
  • clinical and community preventive services,
  • empowering people, and
  • eliminating health disparities.

Source:  http://www.medpagetoday.com/PublicHealthPolicy/HealthPolicy/46573