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What will $5 Billion Buy?

Posted By Administration, Wednesday, February 22, 2012

On Friday, February 17th, the House and Senate approved and sent to the President the Conference Report for the Payroll Tax legislation.  The Bill included a temporary fix to the Medicare Physician Fee Schedule preventing a pending 27% cut in payment rates to physicians under Medicare for 10 months.  Unfortunately, much of the "pay for” came at the sacrifice of the Prevention and Public Health Fund – at a whopping $5 billion!  While use of the Prevention Fund in this manner is short-sighted at best and is an inappropriate use of funds, this action only maintains the unworkable Sustainable Growth Rate (SGR) payment formula for 10 months at the expense of investing in prevention and wellness initiatives that greatly contribute to reducing long-term health care costs.  This temporary fix comes with no incentives to promote real savings in the Medicare program by moving from the current fragmented Fee for Service (FFS) environment to care delivery models which incentivize better health outcomes through more coordinated care. DHPE recommends that Congress focus on ensuring that the Prevention Fund is used for evidence-based prevention and care coordination programs;  programs that have proven to demonstrate significant savings in the private sector time and again.  Manipulating the fund as seed capital to fund and scale programs that will bring long-term savings to the Medicare program, like Community Health Teams and the YMCA Diabetes Prevention Program would provide Americans a far much better return on their tax dollars.  Members please make your voice heard.

All of us had great hope that the Prevention and Public Health Fund, established under the Affordable Care Act (ACA), would provide an investment of $15 billion over its first 10 years in American communities to prevent disease, save lives, and reduce long-term health costs.

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