The Role of Prevention in Bending the Cost Curve

To help finance its historic expansions of insurance coverage, the Patient Protection and Affordable Care Act (ACA) includes several provisions aimed at slowing the rate of growth of personal health expenditures. This goal is addressed partly by reductions in payments to health care providers and partly by future reductions in the tax subsidies for extremely generous insurance plans—often referred to as “Cadillac plans”—to increase the price sensitivity of consumers. Another ACA strategy is a focus on disease prevention to reduce the future need for care. According to polling conducted during the 2009 health care reform debate, the public believes that disease prevention is a key component of improving the long-term prospect of the nation’s health care system, and the rhetoric about reform has often included references to prevention. However, not until the passage of the ACA was health care reform linked to funding for public health and prevention.