Prevention Matters

The Affordable Care Act (ACA) will celebrate its one year anniversary March 23, 2011. Signed into law last year, the ACA puts into place comprehensive health insurance reforms designed to lower health care costs by enhancing the quality of health for all Americans.

The ACA’s small business provisions focus on finding ways for business owners to reduce their heath care costs by ensuring their employees have access to quality, affordable health insurance.

Small business provisions include:

• Small Businesses with fewer than 25 full time employees may qualify for the business tax credit.
• Employer-based health plans that provide health insurance to retirees aged 55-65 can get financial help through the Early Retiree Reinsurance Program.
• Insurance companies will no longer be able to deny individuals with a pre-existing condition, who may now be eligible to join the Pre-Existing Condition Insurance Plan.
• Employees can receive recommended preventive services like mammograms and flu shots without any additional cost to the employee.
• Insurance companies are prohibited from capping the dollar amount of care an employee can receive in a lifetime, or dropping coverage due to a mistake on your application when you get sick.
• Insurance companies must spend at least 80% of premium dollars on healthcare.

Currently four million small business owners have been able to claim a tax credit up to 35% of their health insurance costs. But tax credits are not the only benefit for small business owners. By 2014, small businesses will be able to increase their buying power through state-based health insurance marketplaces. Employers will be able to identify health insurance plans that better meet their needs. The ACA has allowed small business employers to provide health benefits to their employees.

Throughout this week the Small Business Majority will host a series of roundtables and webinars designed to better understand what the ACA has meant to small businesses. Today, the Secretary of the U.S. Dept of Health and Human Services, Kathleen Sebelius will kick off the series in Ohio. The Secretary will join The Consortium of African American Organizations and the National Policy Director of the Small Business Majority. 

Healthy People 2020, the U.S. Department of Health and Human Services' master plan for improving the health of the American population over the next decade, covers 42 topics and nearly 600 objectives.  A new report from the Institute of Medicine singles out 12 indicators as immediate, major health concerns that should be monitored and 24 objectives that warrant priority attention in the plan's implementation. 

The report updates and expands on the 10 leading health indicators that served as priorities for Healthy People 2010.  The recommendations on what should be the priorities for the latest version of this decadal health plan reflect the consensus of a committee comprising population health experts, epidemiologists, health statisticians, and others.  Indicators provide yardsticks that health experts and policymakers can use to measure progress, and objectives set out clear, concrete goals for improvements. 

The 12 recommended indicators include measures of access to care and quality of health care services, healthy behaviors, injury, physical and social environments, chronic disease, mental health, responsible sexual behavior, substance abuse, tobacco use, and healthy births.

The 24 objectives that the committee identified are:

•      Increase educational achievement of adolescents and young adults.
•      Increase the proportion of people with health insurance.
•      Increase the proportion of people with a usual primary care provider.
•      Increase the proportion of people who receive appropriate evidence-based clinical preventive services.
•      Reduce the overall cancer death rate.
•      Reduce the number of days the Air Quality Index exceeds 100.
•      Increase the proportion of children who are ready for school in all five domains of healthy development: physical development, social-emotional development, language, cognitive development, and approaches to learning.
•      Reduce pregnancy rates among adolescents.
•      Reduce central-line-associated bloodstream infections.
•      Improve the health literacy of the population.
•      Reduce coronary heart disease deaths.
•      Reduce the proportion of people with hypertension.
•      Increase the proportion of sexually active people who use condoms.
•      Reduce fatal and nonfatal injuries.
•      Reduce the proportion of people who experience major depressive episodes.
•      Reduce low birth weight and very low birth weight.
•      Reduce the proportion of obese children and adolescents.
•      Reduce consumption of calories from solid fats and added sugars by people age 2 and older.
•      Increase the proportion of adults who meet current federal guidelines for aerobic physical activity and for muscle-strengthening activity.
•      Reduce the proportion of people engaging in binge drinking of alcoholic beverages.
•      Reduce past-month use of illicit substances.
•      Increase the proportion of adults who get sufficient sleep.
•      Reduce tobacco use by adults.
•      Reduce the initiation of tobacco use among children, adolescents, and young adults.

Partnership for Prevention is pleased to learn that in only two months over 150,000 Medicare beneficiaries have received the annual wellness visit authorized in the Affordable Care Act (ACA). This good news comes on the heels of an HHS report earlier this week indicating that those over 65 are not getting the preventive services they need.  Click here for HHS news release.

The ACA requires a health risk assessment (HRA) for Medicare beneficiaries to assist in developing personalized prevention plans. Partnership has been working with the Centers for Disease Control and Prevention (CDC) and the Centers for Medicaid and Medicare Services (CMS) to develop guidance for implementing this important tool. Specifically, Partnership organized and helped lead a Public Forum meeting in response to a Federal Register Notice for public comments and submitted, with Thomson Reuters, a report that CDC will use to inform CMS on the development of guidance for the HRA.

For additional information about Partnership’s work on the annual wellness visit and HRA, please click here or contact Jason M.M. Spangler, MD, MPH, FACPM, Chief Medical Officer, Partnership for Prevention, jspangler@prevent.org.

Adults over the age of 65 are not getting the preventive services that they need, according to a report released by the Department of Health and Human Services on Monday. The report found that preventive services, including vaccinations, tobacco cessation, and screening for cancer, diabetes, lipid disorders, and osteoporosis are underutilized. The report emphasizes that adults over 65 should be taking advantage of preventive services on a regular basis, and notes that many beneficiaries don’t know what services are covered by Medicare.

As a provision of the Affordable Care Act, certain USPSTF A and B recommended preventive services are covered without cost sharing by Medicare patients. In order to promote uptake of preventive services, including those services that are currently underutilized, Medicare has instituted an annual wellness visit. The wellness visit will allow Medicare beneficiaries access to preventive services on a regular and continued basis. It will be based on a detailed Health Risk Assessment (HRA), which allows patients and providers to create a personalized prevention plan. Partnership for Prevention, along with the CDC, has assisted the Centers for Medicare and Medicaid Services (CMS) in the effort to design and implement the HRA by interviewing and convening a group of HRA experts.

Medicare coverage, along with outreach and education for the annual wellness visit, will help to bring awareness to the need for and use of preventive services for those over the age of 65.


Rebecca Doigan, MPH
Research Fellow and Program Associate

Today, Secretary of Health and Human Services Kathleen Sebelius released a report highlighting the health insurance premium and out-of-pocket savings families and businesses can receive under the “Affordable Care Act” in 2014. Between 1999-2009 premiums more than doubled by rising over $7,500 for families that get their health insurance through an employer.

The report outlines several of the provisions the “Affordable Care Act” has and will implement. Provisions already in progress include new resources for states to improve their review of proposed health insurance premium rate increases and the eligibility for small businesses to receive tax credits that covers up to 35 percent of insurance costs of their employees.

The provisions for families that will be implemented disclose the importance of State-based Health Insurance Exchanges to middle-class families and tax credits that reduce cost sharing. Small businesses will also experience significant cost savings. By 2014, small businesses on average could save up to $350 per family policy and will be eligible for tax credits up to 50 percent of premiums. All businesses will likely see lower premiums of $2,000 per family by 2019.

Partnership for Prevention’s new Leading by Example The Value of Worksite Health Promotion to Small and Medium Sized Employers publication provides real examples of successful worksite health promotion programs for small to medium sized employers. The employers highlighted in this publication have taken the initiative to reduce health care costs by increasing the health of their employees. The publication can be downloaded at http://prevent.org/Initiatives/Leading-by-Example.aspx.

For more information please visit:
http://www.hhs.gov/news/press/2011pres/01/20110128a.html

"Best and Worst News for Prevention” is based on a purposive sample consisting of expert staff members who each week choose to share their opinions on the best and worst news for prevention.

BEST

KC Health Department hands out vouchers for flu shots

If you are uninsured in the metropolitan area and still need a flu shot, the Kansas City Health Department has a deal for you: It is handing out 25,000 vouchers for free vaccinations at Walgreens pharmacies. Walgreens donated 350,000 of the vouchers to the U.S. Department of Health and Human Services. The department is distributing them to Kansas City and more than a dozen other areas nationwide where there are disparities in vaccination rates and opportunities to address them.

“They’re targeting people who wouldn’t usually get a flu shot; they don’t have insurance or their insurance doesn’t cover it,” said the Health Department’s Jeff Hershberger. The department last week began handing out thousands of vouchers to community organizations.


WORST

Youths With STDs May Not Admit They Had Sex: Young People Not Always Truthful About Sexual Activity, So Routine STD Screenings Are Needed


Young people who say they’ve abstained from sexual intercourse may not be telling the whole truth, an important finding in the ongoing battle against the spread of sexually transmitted diseases. Researchers at Emory University in Atlanta examined data on 14,012 young adults in their early 20s, who completed a computer-assisted interviewing survey and provided a urine specimen aimed at detecting three common STDs: chlamydia, gonorrhea, and trichomoniasis.

More than 10% of the young people found to have at least one of the STDs had reported not having penile/vaginal sexual intercourse in the past 12 months. This suggests that routine screening of STDs may be a better way to reduce transmission of diseases.


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

Wow….New graphic cigarette health warnings … FDA wants to know what you think.

At a press conference this morning (November 10, 2010) Health and Human Services Secretary Kathleen Sebelius helped unveil a “comprehensive tobacco control strategy that includes proposed new bolder health warnings on cigarettes and advertisements. In 2009 President Obama signed into law the “Family Smoking Prevention and Tobacco Control Act” (Public Law 111-31) which required that the Food and Drug Administration add “nine new larger and more noticeable textual warning statements and color graphic images depicting the negative health consequences of smoking.” The Notice of Proposed Rule Making includes 36 proposed images that are a remarkable and long overdue improvements over the warnings Congress required on cigarette packages and advertising ,back in 1984. The FDA is also conducting an extensive 18,000 person consumer test of the proposed graphic images to help identify the nine that will most effectively help current smokers quit and discourage potential new smokers from starting. The results of the FDA’s consumer research will also be released shortly and public comment will be solicited.

The current deadline for public comment on the proposed 36 images is January 9, 2011. The wording of the nine warnings was specified by the Congress when it enacted Public Law 111-31. These warnings include:

‘‘WARNING: Cigarettes are addictive."
‘‘WARNING: Tobacco smoke can harm your children."
‘‘WARNING: Cigarettes cause fatal lung disease."
‘‘WARNING: Cigarettes cause cancer."
‘‘WARNING: Cigarettes cause strokes and heart disease."
‘‘WARNING: Smoking during pregnancy can harm your baby."
‘‘WARNING: Smoking can kill you."
‘‘WARNING: Tobacco smoke causes fatal lung disease in nonsmokers."
‘‘WARNING: Quitting smoking now greatly reduces serious risks to your health."

The challenge for the FDA is to identify graphic images that best amplify the statutorily mandated wording of the cigarette warnings. Federal law also requires that the warnings and graphic images make up the top 50 percent of the front and back of cigarette packages.

FDA Commissioner Margaret Hamburg said it best: “When the rule takes effect, the health consequences of smoking will be obvious every time someone picks up a pack of cigarettes. This is a concrete example of how FDA’s new responsibilities for tobacco product regulation can benefit the public’s health.

So….take a few minutes to check out the FDA’s proposed new labels.

If you have family and friends who smoke…show them the new labels… get their advice and then tell the FDA.

The FDA has given us all an opportunity to play an important role, individually and collectively, in fighting the nation’s leading cause of premature death and preventable illness. Stronger health warnings, especially if they are accompanied by the 1 800 QUIT NOW cessation number, can help more smokers get access to effective cessation medications and discourage thousands of young people from striking the first match of what can become a lifelong, life threatening addiction.

Lets get to work. Tell the FDA what you think.


E Ripley Forbes
Director, Government Affairs

On August 25th, the U.S. Department of Health and Human Services announced an expansion of Medicare coverage that is supported by many tobacco control advocates around the nation. This new expansion offers coverage of evidence-based tobacco cessation counseling, allowing many more smokers to get the treatment that they need.

Despite the fact that Medicare provides coverage for over 43 million beneficiaries, tobacco counseling was previously only offered to those individuals who were diagnosed with or showed symptoms of a tobacco-related disease. This new benefit provides coverage for tobacco cessation counseling to all smokers. As Secretary Kathleen Sebelius explains, “For too long, many tobacco users with Medicare coverage were denied access to evidence-based tobacco cessation counseling. Most Medicare beneficiaries want to quit their tobacco use. Now, older adults and other Medicare beneficiaries can get the help they need to successfully overcome tobacco dependence.”

Medicare beneficiaries will now be provided coverage for two individual tobacco cessation counseling attempts each year, with a total of eight counseling sessions per Medicare patient each year. This coverage has been expanded under the Affordable Care Act, which requires Medicare to cover a variety of preventive services, including tobacco cessation services. The U.S. Department of Health and Human Services will also provide more guidance in the upcoming months about a new Medicaid benefit offering pregnant women coverage for tobacco cessation treatment.

Tobacco-related diseases will cost Medicare an estimated 800 billion dollars between 1995 and 2015. With this new benefit, however, smokers will receive the help they need to quit and prevent these tobacco-related diseases, providing major health benefits for themselves and huge cost savings for Medicare.

Medicare’s coverage of tobacco cessation counseling eliminates a huge barrier to treatment that previously impeded many smokers who sought help in trying to quit. Such coverage fully supports Partnership for Prevention’s mission to provide comprehensive cessation treatments to all tobacco users. Partnership commends the U.S. Department of Health and Human Services for its tobacco control efforts.

For more information please visit the Centers for Medicare & Medicaid website.

Katie Burggraf
Tobacco Control Team

In 2009, the Obama administration and Congress passed the Health Information Technology for Economic and Clinical Health Act (HITECH) to increase the use of Electronic Health Records (EHR’s). The law authorizes incentive payments through Medicare and Medicaid to clinicians and hospitals when they use EHR’s to achieve improvements in care delivery. On July 13, 2010 Secretary Sebelius announced the final rules to support meaningful use of EHR’s, officially launching a concentrated five-year national initiative to improve the health of Americans and reduce health care costs through their adoption and use.

Earlier this year Partnership for Prevention joined with its colleagues at Trust for America’s Health in submitting public comments on the HITECH rules, requesting that the clinical quality measures have a focus on preventive care, specifically those clinical preventive services that provide the highest value as recommended by the National Commission on Prevention Priorities (NCPP). These include influenza immunization rates, smoking cessation counseling, BMI screening and follow-up, cervical cancer and chlamydia screening, and aspirin therapy. We applauded the Department of Health and Human Services for including public health among its goals for implementation.

While the final rules do not include all the measures recommended, smoking status for patients 13 years old or older was included as a measured functionality. This is a victory for tobacco control advocates because recording smoking status may lead to an increase in the number of patients who receive smoking cessation treatment. The age threshold is important as counseling for adolescent smokers has been shown to be effective, approximately doubling long-term abstinence rates in the multiple studies. Additionally, this measure will be in accord with the 2008 Update to the Public Health Service Clinical Practice Guideline on Treating Tobacco Use and Dependence.

This is an exciting time in healthcare in America. Paper-based treatment, surveillance, and recordkeeping is yielding to same-time health communication. The 2009 law and the July 13 announcement of its rules will go a long way toward operationalizing these advances.

For more information:

http://www.hhs.gov/news/press/2010pres/07/20100713a.html

http://healthcarereform.nejm.org/?p=3732


David Zauche
Senior Program Officer
Partnership for Prevention

1. Require health plans to cover all three types of counseling deemed effective by the PHS Guideline for tobacco cessation: individual (face-to-face), group and proactive telephone counseling.
2. Require health plans to cover all seven medications FDA-approved to treat tobacco addiction.
3. Comprehensive tobacco cessation treatments should be promoted to encourage tobacco users to quit.

The Department of Health and Human Services’ Office of Inspector General (IG) has just released a new report (OEI-05-08-00520) concluding that “Most children in nine selected States are not fully benefiting from Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) comprehensive screening services.”

For anyone concerned about the importance of expanding coverage for clinical preventive services under health reform, this report is a reminder that coverage alone isn’t enough to assure access.

The EPSDT program provides “a comprehensive and preventive child health program for children under the age of 21. Every State Medicaid program must offer the EPSDT benefit…In 2007, 31.5 million children were eligible for EPSDT…Services provided under the EPSDT benefit are intended to screen, diagnose, and treat children eligible for EPSDT services at early, regular intervals to avoid or minimize childhood illness. The EPSDT services cover four health-related areas: medical, vision, hearing, and dental. This study focused on medical, vision, and hearing screenings. Only medical screenings have components specifically required by the statute. Complete medical screenings under the EPSDT benefit must include the following five age-appropriate components: a comprehensive health and developmental history, a comprehensive unclothed physical examination, appropriate immunizations according to age and health history, appropriate laboratory tests, and health education.

States selected for the review included Arkansas, Florida, Idaho, Illinois, Missouri, North Carolina, Texas, Vermont and West Virginia.

The IG found that two primary factors contributed to children not receiving required screenings.

First, children did not receive the correct number of each type of screening. Second, when children received medical screenings, the screenings were often incomplete. These two factors taken together indicate that very few children received the correct number of complete screenings required by law.

Seventy-six percent of children, or 2.7 million children, in the States selected for the review did not receive all of the required number of medical, vision, and hearing screenings. Forty-one percent of children did not receive any required medical screenings. In addition, more than half of children did not receive any required vision or hearing screenings.

Fifty-five percent of children in the nine States received a medical screening during the study period. Of these children, 59 percent lacked at least one component of a complete medical screening. The component that children were missing most often was appropriate laboratory tests.

Officials from all nine selected States identified strategies to improve participation in the EPSDT and the completeness of medical screenings. The disconnection between States’ efforts to improve the EPSDT program and the low number of children receiving required screenings is difficult to account for, but it indicates that additional efforts are required.

Based on these findings, the IG recommended that CMS: (1) require States to report vision and hearing screenings, (2) collaborate with States and providers to develop effective strategies to encourage beneficiary participation in EPSDT screenings, (3) collaborate with States and providers to develop education and incentives for providers to encourage complete medical screenings, and (4) identify and disseminate promising State practices for increasing children’s participation in EPSDT screenings and providers’ delivery of complete medical screenings.

New requirements under Health Reform will require expanded coverage of clinical prevention services under Medicare and new individual and group private plans. To realize the benefits of these services it is essential the Administration require that new coverage be accompanied by effective strategies and resources to encourage participation.

E Ripley Forbes
Director, Government Affairs
Partnership for Prevention

U.S. Department of Health and Human Services Secretary Kathleen Sebelius has named preventing and reducing tobacco use as a strategic initiative for HHS. Sebelius noted that it will require “comprehensive, sustained, and accountable tobacco control efforts based on evidence-based interventions” to lower the current smoking rate of twenty percent in the U.S.

Initial actions identified to increase efforts to prevent and reduce tobacco use include:

• Strengthening the implementation of evidence-based tobacco control interventions and policies in States and communities;
• Changing social norms around tobacco use;
• Accelerating research to expand the science base and monitor progress; and
• Leveraging HHS systems and resources to create a society free of tobacco-related disease and death.

Increasing efforts in the area of tobacco control is a big step in the right direction to ensure that Americans live healthier lives.

Brandi Robinson
Program Associate
Partnership for Prevention

The U.S. Department of Health and Human Services (HHS) has awarded more than $119 million to states and U.S. territories to support public health efforts to reduce obesity, increase physical activity, improve nutrition, and decrease smoking-the four most important actions for combating chronic diseases and promoting health. This money supports the one of several components in the Department's comprehensive prevention and wellness initiative, Communities Putting Prevention to Work, which is funded under the American Recovery and Reinvestment Act of 2009.

The U.S. Department of Health and Human Services has launched its new "Be Active Your Way" blog. The Blog is designed to stimulate dialogue among professionals who encourage Americans to get the physical activity they need according to the Physical Activity Guidelines for Americans.

Several "supporter" organizations serve as blog contributors, and a new blog item is posted each Wednesday. Anyone interested in the conversation can participate, as supporters and other professionals who work in the field of physical activity are welcome to share lessons learned by posting comments.

BEST



Toxins Make Halloween Face Paints Scary
http://health.usnews.com/articles/health/healthday/2009/10/27/toxins-make-halloween-face-paints-scary.html

By voice vote, the U.S. Senate Thursday night confirmed Dr. Regina Benjamin to serve as Surgeon General. Benjamin, 53, was the first black woman to head a state medical society, received the Nelson Mandela Award for Health and Human Rights and just last fall received a MacArthur Foundation "genius grant." In the wake of Hurricane Katrina, she rebuilt her rural health clinic in Bayou La Batre, Ala., which serves 4,400 patients who would be hard-pressed to find care elsewhere.

Benjamin was nominated by President Barack Obama in July, but a month later Republicans put a hold on all health nominees because the administration had imposed a "gag rule" on companies offering Medicare Advantage to seniors. Those companies were sending out information to customers telling them that a Democratic healthcare reform proposal would cut benefits. The Department of Health and Human Services issued a memo in mid-October telling companies they can provide information about legislation that affects them if their customers agree to receive such information.

But Senate Majority Leader Harry Reid (D-NV) blasted Republicans on Thursday for holding up the nomination of Benjamin and other nominees for reasons "completely unrelated to their qualification." In Benjamin's case, concern had been expressed about holding up the confirmation of one of the nation's leading spokespersons on public health when the H1N1 epidemic was spreading.

Dr. John Clarke of Baldwin, New York, rapped his way to victory in the Department of Health and Human Service's flu prevention PSA contest. HHS Secretary Kathleen Sebelius announced that Clarke's "H1N1 Rap" was named the winner after a tally of more than 50,000 v0tes from more than 200 entries from across the country.

Americans were called to create a 15, 30, or 60 second video promoting good hygienic practices and submit this video over YouTube. This video was to inform people about the flu and motivate them to take steps that help prevent the spread of the flu. The winner received $2500 in cash and will be featured on national television.

A panel of 12 video communication and public health experts determined the top 10 entries. These were put on the HHS YouTube Channel and put to a public vote. Over 50 thousand votes were cast in the 18 days that voting was open, and these votes determined the overall winner.

Partnership for Prevention today said it was encouraged by a new initiative at the U.S. Department of Health and Human Services in which economic stimulus funds will be used to reduce risk factors associated with the leading causes of preventable death.

“Tobacco use, poor nutrition and lack of physical activity are driving the overwhelming majority of preventable deaths and chronic illnesses in the United States,” said Partnership President/CEO Robert J. Gould. “Investing in high-impact approaches to reduce these risk factors should yield a handsome return for the country, not only in terms of improved health but also in improved productivity and an improved economy.”

The Centers for Disease Control and Prevention announce the release of $373 million from the American Recovery and Reinvestment Act of 2009 to fund the first part of a new $650 million public health initiative named “Communities Putting Prevention to Work.” The initial $373 million will fund competitive grants awarded to communities to support evidence-based prevention strategies for youths and adults and to promote partnerships across communities and sectors.

Funds will be awarded for projects in two categories: Obesity/Physical Activity/Nutrition and Tobacco Control/Cessation. Approximately 30-40 community awardees will be selected for the initiative. Awards for both categories will vary with size of jurisdiction and the needs of communities. Size of the grants varies from $500,000-$1 million for tribal applicants to $10 million-$20 million for large cities.

Partnership for Prevention had urged Congress to include disease prevention and health promotion projects in the economic stimulus bill, and had also encouraged HHS to invest those funds in high-impact, evidence-based approaches to reduce the major risk factors. Communities that wish to apply for awards can find more information at www.grants.gov.

An additional $277 million will be made available in the coming weeks to states, territories, and other organizations and networks to support and extend the reach and impact of the community projects. The deadlines for the state, territory, and other prevention projects that are part of the Communities Putting Prevention to Work initiative will be announced soon.

WASHINGTON - Prevention was one of six priority areas cited by a federal panel in its recommendations as to how the Secretary of Health and Human Services should spend $400 million in stimulus-bill funding for comparative effectiveness research. The Federal Coordinating Council for Comparative Effectiveness Research (CER) issued its findings in a report issued today. Partnership for Prevention testified before the Council at a May 13 field hearing in Chicago and urged that prevention be made a priority in the recommendations.

"Many effective interventions for improving health are likely to involve prevention and community intervention, but these areas are currently understudied," the council concluded. "For example, behavioral change and prevention have the potential to decrease obesity, decrease smoking rates, increase adherence to medical therapies, and improve many other factors that determine health."

The high-priority interventions cited by the council were medical and assistive devices, procedures/surgery, behavioral change, prevention, and delivery systems.

"Due to astonishing achievements in biomedical science, clinicians and patients often have a plethora of choices when making decisions about diagnosis, treatment, and prevention, but it is frequently unclear which therapeutic choice works best for whom, when, and in what circumstances," the council said. It said CER "should identify interventions that yield the most health improvement and represent the best value wherever and however the interventions are delivered."

Partnership for Prevention President Robert J. Gould expressed appreciation to the council for making prevention a priority and for encouraging Partnership's participation in their listening sessions.

"The council's decision is an important step in giving prevention the footing it needs to take its rightful place in the spectrum of health-care decisionmaking," Gould said. "Everyone wins when consumers and health professionals can make informed decision based upon science-based comparisons that show how we can get the most health benefits for the dollars spent."

"We hope HHS Secretary Katherine Sebelius will follow this blueprint when she makes her final decisions on the federal investment in CER," he said.

The council's report was mandated by the American Recovery and Reinvestment Act, is designed to help the HHS Secretary and lawmakers improve the quality of care for patients, and provide patients and doctors the best information possible to make decisions about health care. The report is available at www.hhs.gov/recovery/programs/cer.