At the Milken Institute's Future of Health Summit last week, Chairman Michael Milken asked a crucial question: How can we make progress in combating chronic diseases? In the U.S., chronic diseases such as heart disease, stroke, cancer, diabetes, and chronic obstructive lung disease have accounted for the majority of deaths and healthcare spending in recent years, and poor health status has been linked to worse outcomes from Covid-19.
These diseases are linked to preventable risk factors such as unhealthy diet, tobacco use, lack of physical activity, social isolation, and poor mental health, which stem from a lack of attention to the social determinants of health, such as nutrition and housing, and an underinvestment in public health and primary care.
Anand Parekh, a former government official, believes the health care system should focus on chronic disease prevention, rather than just chronic care management. He wrote about this in his book Prevention First. He said two actions could help make this shift: change the incentives and scale evidence-based prevention interventions.
Health care providers should be incentivized through quality measures tied to payment to prevent the occurrence of chronic diseases, such as the development and utilization of health status measures related to the incidence of chronic diseases and the prevalence of chronic risk factors. Secondly, prevention programs should be adequately reimbursed, promoted, and scaled by health insurers, such as diabetes prevention, heart disease reversal, physical activity promotion, comprehensive tobacco cessation, and falls prevention.
Chronic disease prevention may not always save health care resources, but it will make the U.S. a healthier and more productive country. Milken was worried that discussing chronic diseases would only lead to worsening health and economic burden. Now is the time to make the changes necessary to improve the nation's health.