When I joined the Robert Wood Johnson Foundation (RWJF) 11 years ago, Steve Schroeder, the president at the time, had a saying that had become famous within these walls: “Execution trumps strategy every time!” As I get bombarded with questions and predictions about how the Patient Protection and Affordable Care Act will affect all Americans, particularly older adults, Steve’s words keep ringing in my ear.
The new law is like the frame of a new house. We still need to build the walls, paint, and decide what it’s going to look like. To help policymakers better analyze, understand, and implement the health reform legislation, the George Washington University School of Public Health and Health Services and the Robert Wood Johnson Foundation launched Health Reform GPS, a comprehensive Web portal. Health Reform GPS will be a valuable resource for policymakers as well as journalists, researchers, policy analysts, and health reform stakeholders looking for comprehensive information about all phases of the law and the process of implementation.
At the same time, the public--especially older adults--are confused about the law and what it means for them and their families. There are some important benefits that many people don’t know about or understand. For example, currently Medicare covers only one wellness visit, when a beneficiary enters the Medicare program. Beginning in 2011, Medicare will provide first dollar coverage for an annual wellness visit with a health professional as well as the development of a personal prevention plan for each person. This annual health assessment will help all those covered by Medicare--primarily older adults and persons with disabilities--to understand their risk for chronic illness and what steps they can take to be healthier. In addition, by eliminating co-pays for certain preventive services, the law will give more Medicare beneficiaries access to recommended services and tests that help prevent or detect disease early. Finally, it offers incentives to both Medicare and Medicaid beneficiaries who complete programs designed to replace unhealthy behaviors with healthier lifestyles. Because private insurance often follows Medicare’s lead, over time the bill may encourage private insurers to also cover these services and tests.
In fact, prevention in general is one of the most underreported and misunderstood elements of the new law. For example, the new law creates a Prevention and Public Health fund that will invest $500 million during this fiscal year on prevention and wellness. That amount will increase to$2 billion annually ($15 billion over ten years). The fund will support community-based programs that promote healthy lifestyles and provide preventive services. This is particularly important, as health starts, grows, and is sustained where we live, learn, work, and play--not in the doctor’s office. While not specifically targeted at older persons, all adults will benefit from these stable investments in public health and health promotion. The fund will focus on promoting physical activity, improving nutrition, and reducing tobacco use. In addition, the Food and Drug Administration will be developing national nutrition labeling standards for food sold in vending machines and chain restaurants with 20 or more locations, due next March.
These changes are a major investment in health promotion and wellness for all Americans. So what does this mean for health and aging services providers, as well as all who care about the health of older adults? It all depends on implementation: as the CEOs of the American Cancer Society, American Diabetes Association, and American Heart Association recently pointed out in a recent article in Politico, “The promise of prevention can be fulfilled only if the new law is implemented effectively and funds are allocated expediently.” If those of us funding in health and aging seize this opportunity to encourage Medicare beneficiaries to take advantage of these new benefits, we can help mid-life and older adults lead healthier and more productive lives.
Robin E. Mockenhaupt, PhD, MBA, is chief of staff at the Robert Wood Johnson Foundation.