Wednesday, April 22, 2009

Major Stakeholders in Health Reform Debate Call for Improvements in Scoring of Congressional Health Care Proposals

/PRNewswire / -- More than 100 members of the Partnership to Fight Chronic Disease (PFCD) - an organization representing some of the nation's biggest voices in health care - today called on leaders in Congress to encourage updates in the manner in which the Congressional Budget Office (CBO) produces estimates for the cost of legislative proposals in health care. Specifically, they called out limitations in the current methods that, once corrected, would more accurately recognize the value of health care efforts aimed at attacking a significant driver of health care costs: the unchecked growth in common and costly chronic diseases, and related problems such as obesity.

In a letter to House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid, the 150 partners and affiliated organizations that signed the letter ask that, "As our nation considers comprehensive health reform proposals, we hope that you will encourage the Congressional Budget Office to address barriers to recognizing the economic value of prevention and chronic disease management."

The group outlined several recommendations for updating the manner in which CBO scores health care proposals including:

-- A revision of "baseline" cost estimates to take in to account the
deteriorating health status of the population and the estimated impact
of this trend on spending in the years ahead
-- The ability to score savings beyond the commonly-accepted 10-year
scoring window in order to sufficiently capture the long-term value of
population health improvement programs
-- An estimate of the broader economic impact a policy change to promote
population health will have on productivity, and ultimately, the

In particular, the group said that it wants to encourage the CBO to find ways to incorporate the benefits of targeted interventions with proven success, as identified in the growing body of research on this issue, and estimate what the impact of these changes could be over the short and long-term.

Chronic diseases, such as diabetes, heart disease, are responsible for seven out of 10 deaths and affect more than 130 million Americans. The annual economic impact on the U.S. of the seven most common chronic diseases is estimated to be $1.3 trillion, which could balloon to nearly $6 trillion by 2050.

Full text of the letter to Speaker Pelosi and Senator Reid follows.

About the Partnership to Fight Chronic Disease:

The Partnership to Fight Chronic Disease (PFCD) is a national and state-based coalition of patients, providers, community organizations, business and labor groups, and health policy experts committed to raising awareness of the number one cause of death, disability, and rising health care costs in the U.S.: chronic disease. For more information about the PFCD and its partner organizations, please visit:

April 21, 2009

Dear Speaker Pelosi and Majority Leader Reid:

As members of the Partnership to Fight Chronic Disease (PFCD), we thank you for your leadership in Congress and support of President Obama in making health care reform a priority in 2009.

When it comes to the health of the American people, our nation currently faces a crisis. Despite all the resources being spent on health care in the United States, many Americans struggle with their health. Millions suffer from common and costly chronic health conditions such as diabetes, heart disease, and obesity. The rapid growth in these problems has caused individual health costs to soar, undercut U.S. competitiveness and burdened the public health insurance infrastructure.

Spending on patients with one or more chronic diseases now represents more than 75 percent of total spending on health care in the U.S., and even more in public programs such as Medicare and Medicaid. Until we address the true causes of this crisis, we will never be able to slow spending or make health care more affordable. Nor we will have a workforce - or an economy - that can perform to its fullest potential.

The PFCD, a national and state-based coalition of hundreds of patient, provider, community, business and labor groups, is committed to raising awareness about this issue, while also providing commonsense, bipartisan solutions to help solve the problem. We believe that investing in prevention and disease management will save lives and money now and well into the future. Recognition of the opportunity to achieve the long-term benefits of investment in these areas would provide a positive framework for health policy decisions.

As our nation considers comprehensive health reform proposals, we hope that you will encourage the Congressional Budget Office to address barriers to recognizing the economic value of prevention and chronic disease management. There are three key points that lead to insufficient recognition of the opportunities offered by investments in prevention and disease management:

-- The current government scoring windows cannot sufficiently capture the
long-term value of population health improvement programs aimed at
wellness and prevention.
-- Health care expenditure estimates depend critically on the assumptions
made in the baseline, including projected changes in the current
health status of the population and the estimated impact of health
status trends. Currently, these assumptions are not transparent.
-- CBO scoring does not currently include analysis of the broader
economic impact a policy change will have through changes in
population health and productivity. Estimates of this societal cost
impact would be of great value to legislators.

Such a holistic and comprehensive approach to reform is the only way that we will truly help improve Americans' health, spend our limited health resources more wisely, and boost our economy.

Thank you, in advance, for your support.


The undersigned Partnership to Fight Chronic Disease national and state partners and other concerned organizations (see full list below)

National partners and other concerned organizations:

AdvaMed (Advanced Medical Technology Association)
Alliance for Aging Research
Alzheimer's Foundation
American Academy of Nurse Practitioners
American Academy of Nursing
American College of Physicians
American College of Preventive Medicine
American Dietetic Association
American Osteopathic Association
American Pharmacists Association
American Society of Health-System Pharmacists
Arthritis Foundation
Cleveland Clinic
Community Health Charities of America
The COSHAR Foundation
DMAA: the Care Continuum Alliance
Easter Seals
Healthcare Leadership Council
Health Dialog
Intercultural Cancer Caucus
IHRSA: International Health, Racquet & Sportsclub Association
Marshfield Clinic
Medical Fitness Association
Men's Health Network
Milken Institute
National Alliance for Caregiving
National Alliance on Mental Illness
National Association of Chronic Disease Directors
National Business Coalition on Health
National Changing Diabetes(R) Program
National Family Caregivers Association
National Health Foundation
National Latina Health Network
National Multiple Sclerosis Society
National Patient Advocate Foundation
Novo Nordisk
Park Nicollet Health Services
Pharmaceutical Research and Manufacturers of America
Pharos Innovations Prevent Blindness America
Self chec, Inc.
YMCA of the USA

State partners:

Arkansas Respiratory Health Association
Lupus Foundation of America, Arkansas Chapter

Alliance of Health Disparities
Colorado Cross Disability Coalition
Colorado Gerontological Society
Lupus Foundation
Mission Medical Clinic
National Association of Hispanic Nurses
National Alliance on Mental Illness
Rocky Mountain Stroke Association

AFSCME Council 31
Arthritis Foundation of Greater Chicago
Community Health Charities Illinois
Mental Health Summit
Midwest Business Group on Health
Mount Prospect Chamber of Commerce
NAACP Lake County
Springfield YMCA
United Way of Lake County

Arthritis Foundation
Community Health Charities of Iowa
Iowa Biotechnology Association

Maryland Academy of Family Physicians

American Cancer Society of Minnesota
Arthritis Foundation, North Central Chapter
Minneapolis Urban League
Sabathani Community Center
United Cerebral Palsy of Minnesota

New Hampshire
Advanced Laser Therapy
AIDS Services for the Monadnock Region
Council for Children and Adolescents with Chronic Health Conditions
New Hampshire Association for Acupuncture and Oriental Medicine

New Jersey
Action Cystic Fibrosis
Carpenters Fund of New Jersey
HealthCare Institute of New Jersey
Juvenile Diabetes Awareness Council of New Jersey
Lung Cancer Circle of Hope
Mental Health Association in New Jersey
New Jersey Association of Mental Health Agencies
New Jersey Association of Osteopathic Physicians and Surgeons
New Jersey Hospital Association
Partners in Care
Steamfitters Local 475

North Carolina
Alliance of Disability Advocates
Arc of North Carolina
Autism Society of North Carolina
Children and Family Services Association of North Carolina
Easter Seals UCP North Carolina
National Alliance on Mental Illness-NC
National Association of Social Workers-NC
National Multiple Sclerosis Society, NC Chapters
North Carolina Mental Health Association
North Carolina Psychological Association

The Academy of Medicine of Cleveland & Northeastern Ohio
Area Health Education Centers - Ohio
Statewide Program
Arthritis Foundation of Central Ohio
Chris Holland, Oregon City Schools, Ohio
Cleveland Clinic
Columbus Public Health
County Commissioners Association of Ohio
David C. Epstein M.D. MBA
Fairhill Partners
The Free Medical Clinic of Greater Cleveland
National Alliance on Mental Illness Ohio
Ohio Alliance of YMCAs
Ohio Association for Health, Physical Education, Recreation & Dance
Ohio Association of Free Clinics
Ohio Association of School Nurses
Ohio Asthma Coalition
Ohio Dietetic Association
Ohio Nurses Association
Ohio Osteopathic Association
Ohio Public Health Association
Stark Prescription Assistance Network
Ohio State University Medical Center
Prevent Blindness Ohio
United Cerebral Palsy of Central Ohio
University of Toledo

South Carolina
Black Nurses Association of South Carolina
Chi Eta Phi, Delta Eta Chapter
South Carolina Diabetes Today Advisory Council
South Carolina Public Health Institute
United Way Association of South Carolina
YMCA of Greenville

AIDS Resource Center of Wisconsin
Metropolitan Milwaukee Association of Commerce
Wisconsin Association of Health Underwriters
Wisconsin Dietetic Association
Wisconsin Manufacturers and Commerce

cc: Douglas Elmendorf, Director, Congressional Budget Office; Keith Fontenot, Associate Director for Health Programs, Office of Management and Budget; Bob Kocher, Special Assistant to the President for Health Care, National Economic Council; Nancy-Ann DeParle, Director, White House Office of Health Reform; Senate Health, Education, Labor, Pensions Committee; Senate Finance Committee; House Ways & Means Committee; House Energy & Commerce Committee; Kate Leone, Senior Health Counsel, Senator Reid's Office; Wendall Primus, Policy Advisor, Speaker Pelosi's Office

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