The Truth about the Prevention Fund

July 10, 2013
by Laura Segal
Altarum Health Policy Forum

With the passage of the Affordable Care Act (ACA), the federal government made a strong commitment to truly invest in proven, effective prevention programs. The ACA created the Prevention and Public Health Fund, the nation’s first step in bolstering the support state and local governments, community organizations, businesses and other groups receive to invest in prevention initiatives.

In June of this year, the Trust for America’s Health (TFAH) issued a new report, The Truth about the Prevention and Public Health Fundrecognizing the impact that the Fund is having.

The Prevention Fund is the nation’s largest single investment in prevention. It uses evidence-based and innovative partnership approaches to improve the health of all Americans. The goal is to support communities as they address the biggest health threats facing their neighborhoods. This helps ensure Americans are happier, healthier, and more productive—we will miss school and work less frequently and even cut down on how often we need to go to the doctor’s office.

The Fund provides more than $14.5 billion in mandatory appropriations over 10 years to prevent chronic illnesses by expanding preventive care and supporting proven, community-based programs that reduce obesity and tobacco use and address other, preventable conditions.

Quite simply, the Prevention Fund is the best and most targeted effort the nation has made toward getting the health of this country back on track—and there have been some great successes in a relatively short period of time.

The Prevention Fund invests in programs that are proven and effective. Oversight and evaluation are key components of every Fund-sponsored program, and strict performance measures ensure accountability before federal dollars are spent. The Fund supports community-driven prevention efforts targeted at reducing tobacco use, increasing physical activity, improving nutrition, expanding mental health and injury-prevention programs, and improving other prevention activities. 

For instance, one component of the Fund—the Community Transformation Grants (CTGs)—is expected to improve the health of 130 million people—more than four out of 10 Americans. In 2011, $103 million was awarded to 61 communities in 36 states, serving approximately 120 million Americans. In 2012, $70 million was awarded to 40 communities, directly affecting about 9.2 million Americans. 

CTG grantees are required, within five years, to reduce by five percent death and disability due to tobacco use; the rate of obesity (through nutrition and physical activity approaches); and death and disability due to heart disease and stroke. States and local communities have the flexibility to decide what problems are most pressing for them to address and decide which approaches to use, as long as they are evidence based. All grantees are expressly forbidden from using any funds for lobbying. The Centers for Disease Control and Prevention (CDC) has put in extra controls to monitor use of funds, and it has mechanisms in place to identify any violations. No violations have been confirmed.

For example, a CTG helped create a new healthcare model—an Accountable Care Community (ACC) in Akron, Ohio—that builds on the Accountable Care Organization approach by not only coordinating healthcare but also by going further to give patients needed support outside the doctor’s office. The approach is paying off. In just 18 months, the Akron ACC has completed two projects with individuals who have type 2 diabetes. A comprehensive program that connected individuals to community resources tailored to their needs reduced medical costs by 10% per month. The second project, a diabetes self-management program, resulted in estimated program savings of $3,185 per person per year.

Another example of how CTGs are sparking effective innovation is in Iowa. Here the Department of Public Health is using a portion of their CTG to provide local communities with resources to better address obesity and other preventable health problems, most notably by creating the Iowa Community Referral Project. The project gives doctors in some communities the ability to refer patients directly to programs in the community that can help provide ongoing support to improve nutrition and increase physical activity. For instance, now if someone has pre-diabetes, instead of the doctor just telling them to eat better and move more, the patient can be connected with counselors or programs available through the local YMCA, so they have more opportunity to carry out their doctor’s advice.

Obesity, tobacco-use, and other preventable health problems are crippling this nation. The Prevention Fund provides states and communities with the flexibility to address their most pressing health challenges. We will never be successful unless we invest in programs and approaches we know work.

Further information on the Fund and CTGs working in the community are available here and

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