Skip to main content

Currently Skimming:

2 Paying for Population Health Improvement: An Overview
Pages 5-12

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 5...
... The first step toward creating dependable and long-term revenue streams for population health will be to reallocate savings from ineffective health care expenditures, Kindig said, "but we will need to go beyond that to expand to ‘health in all policy' investments as well, especially finding the sweet spots where the core missions of other sectors align with health improvement objectives." Doing so, he added, will require new evidence regarding the relative cost effectiveness of different investments, but waiting decades to gather that evidence and act is not acceptable. Where the Roundtable can add value to this effort, he said, is to "lead the call for the development of optimal cross-sectoral financial investment or policy 5
From page 6...
... The budget should apportion less funding to health care spending, he said, and instead include adequate resources for public health agencies as well as for other sector investments that promote health, such as education, housing, and economic development. The 2012 IOM report For the Public's Health: Investing in a Healthier Future recommended that annual governmental public health spending should increase from $11.6 billion to $24 billion, which would at least partially address the $20 billion annual shortfall in governmental public health spending that Trust for America's Health highlighted in a 2008 report (Trust for America's Health, 2008)
From page 7...
... One source would be from savings in health care and the hospital community benefit requirement expanded by the Affordable Care Act.1 Kindig explained that, contrary to the common perception that community benefit funds go primarily toward charity care, data from the Internal Revenue Service show that 25 percent of these funds go toward uncompensated services provided to patients who are unable to pay, 5 percent is spent on community health improvement, and almost 60 percent, or nearly $40 billion, goes toward Medicaid discounts or other money-losing services.2 Kindig offered his opinion that some, though not all, of the approximately $40 billion, could be marginally redirected in more health-promoting ways. A second source of support, he said, would be to get more health from what is already being spent in other sectors, including the community development opportunities that other speakers at the workshop would address in a subsequent session.
From page 8...
... NOTE: Counties are ranked by the per capita death rate, which is adjusted for the age distribution in each county. SOURCE: Kindig presentation, 2014.
From page 9...
... We need to move beyond grants and short-term appropriations and move to dependable formula sources such as those dedicated to crop subsidies, mortgage interest deductions, or Medicare medical education payments that are not annual grant renewal items." Kindig also remarked that the medical and public health practice community needs to use its political clout to support investments in other sectors, such as early childhood development, that also benefit public health. "Those are win– win opportunities," he said, echoing the 2012 IOM report For the Public's Health: Investing in a Healthier Future.
From page 10...
... He responded to Knickman's comments by saying that even within the narrow constraints of the CMS savings program, population health initiatives have begun and that being able to reinvest Medicaid savings in social determinants of health, such as housing support, is a promising opportunity.3 He also said there is a need for a thorough and consistent accounting of governmental public health spending, a suggestion that was echoed by Michelle Larkin of the Robert Wood Johnson Foundation. Larkin mentioned that a group of public health experts is currently developing a standardized system to track resources, expenditures, and inputs.
From page 11...
... Kindig acknowledged that he does not have an answer for the amount of money needed, but he pointed to promising examples of investing in early childhood programs and involvement of the business community. He also noted the challenges that restrictive financial policies pose for moving money from one budget to another.


This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More information on Chapter Skim is available.