Community-based health programs aimed at diet, exercise, smoking prevention and other known risk factors for chronic diseases could cut health-care costs in the United States by $16 billion a year, at a cost of 10 dollars per patient/year, a new report says.
We worked with economists at the Urban Institute who looked at health-care costs associated with these chronic diseases," said Jeffrey Levi, executive director of the Washington-based Trust for America’s Health, which issued the report. "They estimated a 5 percent reduction in these chronic diseases to derive these savings."
The estimate was based on a model developed at the Urban Institute and a review of studies on the cost and effectiveness of prevention programs by experts at the New York Academy of Medicine.
Spending $10 a year per person would save the United States more than $16 billion annually within five years, the economists said, for a return of $5.60 on every $1 invested. Their survey showed that effective prevention programs costing less than $10 per person could reduce rates of type 2 diabetes and high blood pressure by 5 percent within two years, reduce heart disease, kidney disease and stroke by 5 percent within five years, and reduce some forms of cancer, arthritis and lung disease by 2.5 percent in 10 to 20 years.
Who would pay for the prevention programs? Primarily the same agencies that promote prevention programs now, such as the U.S. Centers for Disease Control and Prevention, and other agencies, along with state and local health departments, according to Levi.
"But since private insurance companies and Medicare and Medicaid would benefit, the question is whether some of these resources should be tapped," Levi said.
Medicare would save more than $5 billion a year, Medicaid would save more than $1.9 billion and private health insurers would save more than $9 billion, the economists estimated.
Levi said the report is "a call to action for people to recognize the importance of investing in these kinds of prevention measures."
"The programs recommended by the Trust for America’s Health is an absolutely complementary approach" to preventive measures recently proposed in a collaboration by the American Heart Association, the American Cancer Society and the American Diabetes Association, said Dr. Rose Marie Robertson, chief science officer of the heart association.
"In the paper we just published, we looked at the concept that if people in the United States have some risk factor for cardiovascular disease, cancer or diabetes, they should see a health provider and get guidance to reduce or eliminate the risk factor," Robertson said.
Both approaches concentrate on the same risk factors, such as high blood pressure, smoking and lack of physical activity, but one proposes community programs, and the other suggests individual activity guided by physicians, she said.
The endpoints measured in the two programs were different. "What we looked at primarily was the life years saved," Robertson said. "People would not only live longer but have good quality years. They would add millions of quality-adjusted life years."
People worried about known risk factors should see a physician, she said. "There is a cost to doing that, but it doesn’t cost as much as many of the things we think are reasonable. And you get great bang for the buck."
The full report on preventive programs and the money they would save is available from the Trust for America’s Health.