Do Prevention Or Treatment Services Save Money? The Wrong Debate
ABSTRACT Health improvements and cost savings are achievable by providing targeted, evidence-based, and cost-effective health promotion and disease prevention programs that reduce modifiable risk factors, often the cause of costly chronic diseases. Adopting commonsense health practices does not require expensive technology, medication, specialty training, or elaborate treatment facilities. Instituting environmental, policy, and normative interventions, in addition to individual behavior change programs, can shift our thinking about how we pay for health. Employers' efforts in providing health promotion programs to their workers offer a microcosm of how prevention can lead to populationwide risk reduction and cost savings.
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ABSTRACT: Coronary heart disease (CHD) is a major cause of death and important driver of health care costs. Recent German health care reforms have promoted integrated care contracts allowing statutory health insurance providers more room to organize health care provision. One provider offers KardioPro, an integrated primary care-based CHD prevention program. As insurance providers should be aware of the financial consequences when developing optional programs, this study aims to analyze the costs associated with KardioPro participation. 13,264 KardioPro participants were compared with a propensity score-matched control group. Post-enrollment health care costs were calculated based on routine data over a follow-up period of up to 4 years. For those people who incurred costs, KardioPro participation was significantly associated with increased physician costs (by 33%), reduced hospital costs (by 19%), and reduced pharmaceutical costs (by 16%). Overall costs were increased by 4%, but this was not significant. Total excess costs per observation year were €131 per person (95% confidence interval: [€-36.5; €296]). Overall, KardioPro likely affected treatment as the program increased costs of physician services and reduced costs of hospital services. Further effects of substituting potential inpatient care with increased outpatient care might become fully apparent only over a longer time horizon. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.Health Policy 01/2015; 123. DOI:10.1016/j.healthpol.2015.01.012 · 1.73 Impact Factor
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ABSTRACT: The purpose of the thesis was to explore the issues surrounding the cost and implementation of prevention. Specifically, methods for determining cost-effectiveness and measuring the health benefits conferred from prevention were explored and services that have been determined to be cost-effective were discussed. Through interviews with health care professionals, administrators, and public health professors, perceptions of the benefits and costs of prevention were explored. Barriers to the implementation of prevention were discussed. The thesis concludes with suggestions on steps that health care providers and policy-makers can take to improve the health of the U.S. population through prevention.