May 08, 2019

Democratic, Republican and Independent Lawmakers Want to Change the Way Preventive Care Cost-Savings Are Calculated

Cardin, Crapo, King unite with DeGette and Burgess to direct the Congressional Budget Office to more accurately reflect the cost-savings of preventive health care

WASHINGTON – U.S. Senators Ben Cardin (D-Md.), Mike Crapo (R-Idaho) and Angus King (I-Maine) have joined with Congresswoman Diana DeGette (Colo.-01) and Congressman Michael C. Burgess, M.D. (Texas-26) to introduce the Preventive Health Savings Act of 2019, which would direct the Congressional Budget Office (CBO) to more accurately reflect the cost-savings of preventive health care, including screenings. The legislation also would allow the Chairman or Ranking Member of the House or Senate Budget Committee, or the health committees—HELP, Finance, Ways and Means, or Energy and Commerce – to  request an analysis of preventive measures extending  beyond the existing 10-year window to two additional 10-year periods. Senators Cardin and Crapo are members of the Senate Finance Committee.

“Prevention – early detection through screenings like mammograms, and changes in behavior to reduce risks like quitting smoking – lowers health care costs by reducing the expense and severity of treatments. As our nation shifts its focus to more preventive health care, our budgets and accounting methods should shift too,” said Senator Cardin. “Our neglect of prevention has been costly, overwhelming our healthcare budgets, particularly Medicare and Medicaid. Our budget rules are long overdue for a change.”

“This bipartisan legislation includes a basic fix to allow the Congressional Budget Office to articulate the long-term savings achievable through preventive health care,” said Senator Crapo.  “The Preventive Health Savings Act would equip lawmakers with more accurate information when considering legislation to improve the American health care system.” 

“Preventive care can not only saves lives, but can also help Americans avoid chronic diseases before they wreak havoc on our health and our wallets,” said Senator King. “Right now, Congress measures the financial impacts of preventive health programs in a relatively narrow ten-year window, but the full benefits of prevention sometimes can’t be seen for decades. If we’re going to accurately measure the impact of prevention, we need to be looking further ahead – this legislation will do that, and ensure that Congress is pursuing long-term, cost-effective solutions rather than short-term savings. 

“The healthier we are as a society, the less we have to spend on health care,“ Rep. DeGette said. “It’s that simple. And that’s why it’s critical, as we look for ways to make health care more affordable for all Americans, that the CBO be allowed to provide us the most accurate information possible as to how these preventive health measures work to lower our nation’s long-term health care costs.”

“As a physician, I have witnessed firsthand the lifesaving potential of preventive health care services and screenings. In the 21st century, Americans are fortunate that preventive care can reduce both the human and monetary costs of disease. As health care innovation continues to advance, Congress remains ill-equipped to properly budget for long-term costs,” said Rep. Burgess. “Allowing the CBO to project past the current ten year scoring window will provide for a more accurate calculation of the savings of preventive health program, and will allow Congress to better serve the health care needs of the American people.”

To ensure that CBO’s projections link to real scientific data, the Preventive Health Savings Act would define preventive health as “an action designed to avoid future health care costs that is demonstrated by credible and publicly available epidemiological projection models, incorporating clinical trials or observational studies in humans, longitudinal studies, and meta-analysis.”  This narrow, responsible approach encourages a sensible review of health policy that Congress believes will promote public health, and it will make it easier for us to invest in proven methods of saving lives and money.

According to the U.S. Centers for Disease Control and Prevention, four health risk behaviors—lack of physical activity, poor nutrition, tobacco use, and excessive alcohol consumption—are responsible for much of the illness, suffering, and early death related to chronic diseases. By addressing just these four behaviors, we can alter the trajectory of chronic disease and the health costs associated with them.

More than 80% of all adults and 80% of youth do not meet recommendations for aerobic physical activity based on the 2008 Physical Activity Guidelines for Americans.

A broad coalition of groups have endorsed this approach to calculating the real cost savings of preventive care, including: Academy of Nutrition and Dietetics; ACT | The App Association; Aetna; Aetna;  Alliance for Aging Research; Allscripts; Alzheimer’s Association; Alzheimer’s Impact Movement (AIM); America’s Essential Hospitals; America’s Health Insurance Plans (AHIP); American Art Therapy Association; American; Association for Cardiovascular and Pulmonary Rehabilitation (AACVPR); American Association for Respiratory Care (AARC); American Association of Clinical Endocrinologists (AACE); American Association of Diabetes Educators; American Association on Health and Disability; American Clinical Laboratory Association (ACLA); American College of Gastroenterology; American College of Occupational and Environmental Medicine; American College of Preventive Medicine; American College of Radiology; American Council on Exercise; American Diabetes Association; American Foundation for Suicide Prevention; American Medical Association; American Optometric Association; American Osteopathic Association; American Pharmacists Association; American Podiatric Medical Association (APMA); American Psychological Association; American Society for Metabolic and Bariatric Surgery; AmerisourceBergen Corporation; AMGA; Amgen; Ascension Health; Association for Ambulatory Behavioral Healthcare; Association for Behavioral and Cognitive Therapies; Baxter; Biocom; BioReference Laboratories; BlueCross BlueShield of Tennessee; Boehringer Ingelheim; California Life Sciences Association; Cancer Support Community; Cardinal Health; Clinical Social Work Association; Connected Health Initiative; Council for Affordable Health Coverage; Depression and Bipolar Support Alliance; Diabetes Hands Foundation; Dialysis Patient Citizens; Eating Disorders Coalition; Eisai; Eli Lilly and Company; Endocrine Society; Facing Addiction; Hazelden Betty Ford Institute for Recovery Advocacy; Healthcare Information and Management Systems Society (HIMSS); Healthcare Leadership Council; HealthyWomen; IHRSA: International Health, Racquet & Sportsclub Association; Indiana University Health; Johnson & Johnson; Lakeshore Foundation; Leidos; Lewin and Associates LLC; Marshfield Clinic; Maxim Healthcare Services; MemorialCare Health System; Mental Health America; Merck; National Alliance of State Pharmacy Associations; National Assn for Rural Mental Health; National Association of County Behavioral Health and Developmental Disability Directors; National Association for the Self-Employed; National Association of ACOs; National Association of Chain Drug Stores (NACDS); National Association of Psychiatric Health Systems; National Association of Social Workers; National Association of Spine Specialists; National Coalition for Promoting Physical Activity; National Coalition on Health Care; National Consumers League; National Council on Aging; National Kidney Foundation; National Recreation and Park Association; National Restaurant Association; National Retail Federation; Nestle Health Science; Novartis; Novo Nordisk; NTCA–The Rural Broadband Association; Obesity Action Coalition; Obesity Medicine Association; Obesity Society; Omada Health; Partnership to Fight Chronic Disease; Patients Rising; Pediatric Endocrine Society; Pfizer; PhRMA; Premier Healthcare Alliance; Prescriptions for a Healthy America; Prevent Cancer Foundation; Redstone Center; Rite Aid; Sanofi US; SCAN Health Plan; Society for Women’s Health Research; Sports & Fitness Industry Association; Stroll Health; Takeda Pharmaceuticals; Texas Health Resources; Third Way; UAW Retiree Medical Benefits Trust; Underwriters Laboratories INC.; U.S. Chamber of Commerce; Visiting Nurse Associations of America (VNAA); Vizient; Weight Watchers; YMCA of the USA.