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PI Report Looks at New Ways to Fund Community Prevention 

How can we start paying for things that make people healthier, instead of just treating them when they get sick? The Affordable Care Act has helped catalyze an explosion of ideas about how to expand access to healthcare and control costs. We know that community prevention—changing the social and physical environments of communities to keep people healthy in the first place—can go a long way. In this report, we identify new, cutting-edge ways to pay for these efforts.

Prevention Institute researchers talked to health-system innovators around the country to identify emerging new approaches. The result, How Can We Pay for a Healthy Population? Innovative New Ways to Redirect Funds to Community Prevention, doesn't provide all the answers about how to fund prevention but is intended to serve as a catalyst to encourage more innovation. The pioneers we profile in this report have found surprising new ways to capture funds already in the healthcare system and redirect them to pay for population health measures that prioritize community prevention.

Some, like “health impact bonds,” aim to use market mechanisms in a radical new way to reduce the severity and cost of chronic health conditions, returning part of the savings to investors and reinvesting the rest in expanded prevention. Others, like the establishment of the Massachusetts Prevention and Wellness Trust, create funding pools through small taxes on health insurers and hospitals that will be used to fund evidence-based community prevention efforts. All aim to keep people healthy and reduce the cost of the chronic health conditions that eat up three-quarters of our $2.7 trillion annual healthcare bill.

Some efforts can be enabled or scuttled in the coming months based on how statutes and regulations are interpreted. For example, nonprofit hospitals and health plans are required by federal law to spend “community benefit” funds in ways that benefit the public. Efforts are underway to devote a larger portion of these monies to wellness and prevention initiatives that increase people’s access to healthy food or safe places to engage in physical activity.

This report is the first in a series of analyses PI will release in 2013 to explore new approaches aimed at creating a more integrated system for health  and community well being. We hope you’ll read this new report, think about it, and share it with your friends and colleagues. And as always, we’d like you to stay tuned so we can ask for your help in supporting these kinds of innovations at critical moments in the coming months.