Innovations in Financing Chronic Care Preventive Services

March 16, 2007
State Capitol, Room 3191
10:15 – 11:45 am

Session Objective:

Most policymakers acknowledge that our health care system is based on financial incentives for the provision of acute care services rather than preventive services. We pay for medicine for persons with diabetes, but often do not cover nutrition counseling or patient self-management classes, which are preventive services that help patients effectively manage their chronic diseases. The prospect of overhauling our reimbursement system – especially without national leadership – is daunting. There are, however, examples of counties and community-based organizations that are working individually and sometimes in concert, to provide preventive care to persons with chronic conditions, and receive reimbursement for those services. This CAHPF session provided examples of innovative approaches to financing chronic care preventive services.

Key Questions Answered:

• What options are available to states, counties, and community-based organizations that want to cover secondary prevention services such as care management for people with chronic conditions?
• What changes need to be made in health care delivery and payment systems to implement such policies/programs?
• What outcomes are desired (e.g., improved quality of health care, cost savings) when these services are paid for? Are these reasonable expectations?

Panelists included Jeffrey Guterman, MD, MS (Senior Medical Director, Los Angeles Department of Health Services), Athena Philis-Tsimikas, MD (Executive Director and Chief Medical Officer, The Whittier Institute for Diabetes and Project Dulce) and Antronette K. Yancey, MD, MPH (Professor, Department of Health Services, UCLA School of Public Health)