The Economic Benefits of a More Physically Active Population: An International Analysis

The Economic Benefits of a More Physically Active Population: An International Analysis. RAND Corporation.  Marco Hafner et al. November 5, 2019.

It is estimated that about 30 per cent of the global population is considered to be physically inactive. Such inactivity is of high concern when the physical and mental health benefits of physical activity are well established, and that research shows that regular physical activity is associated with lower onset rates of a range of disease conditions. Research also illuminates the stark fact that physical inactivity is associated with more than 5 million deaths every year. With the global rates of physical activity diminishing, and the associated costs to humankind increasing as a result, the insidious and dangerous nature of such global inactivity is becoming increasingly exposed.

In recognition of this, and in order to explore how these high levels of physical inactivity drive cost in economies, the Vitality Group asked RAND Europe to conduct an economic analysis of the potential economic benefits associated with getting people to be more physically active. Using a multi-country computable general equilibrium (CGE) macroeconomic model, RAND Europe examined the potential global implications of insufficient physical activity and changes of physical activity levels at the population level across different countries. The overarching aim of the study was to explore the main economic costs of physical inactivity and to identify the key benefits to improving activity rates. By presenting this data via the three modelled scenarios, the consequence of higher inactivity compared to improved activity rates may be better understood. [Note: contains copyrighted material].

[PDF format, 189 pages].

Improving Chronic Illness Management in Harlem: Leveraging Community Health Coaches to Address the Challenge of Medication Management

Improving Chronic Illness Management in Harlem: Leveraging Community Health Coaches to Address the Challenge of Medication Management. Urban Institute. Elaine Waxman et al. October 24, 2019

Since 2012, City Health Works in Harlem, New York, has hired clinically supervised, neighborhood-based health coaches to support low-income patients manage chronic illnesses like diabetes and hypertension. Medication management is a major focus of this work. Here, the authors present the major reasons for medication issues, including those that required “escalations” to clinical supervisors. They also discuss the unique ways that community-based coaching can help address medication management challenges that emerge in patients’ daily lives (e.g., multiple medications or food insecurity). Finally, they recommend several action items for medical training and practice, aimed at improving the delivery of patient-centered care. [Note: contains copyrighted material].

[PDF format, 34 pages].

A New Vision for Health Reform

A New Vision for Health Reform. Brookings Institution. Joseph Antos and Alice M. Rivlin.  September 24, 2019

Health spending is the largest component of the federal budget.  Left unchecked, federal health spending is expected to double over the next decade.  A similar sharp increase in health spending is projected for consumers, employers, and state governments. A viable agenda for growing the economy must include policies to control the growth of health care spending while promoting access to affordable, quality health care and better health outcomes. Otherwise, there is a big risk that much of the federal budget and the economy’s future growth will be absorbed by an excessively costly health system without appreciable gains in health.  Controlling costs will require a comprehensive approach that addresses the root causes of high spending. It must increase competitive pressures on health care prices, both from the demand- and supply-sides, allowing pressure from patients to help control costs. This paper details how to arm purchasers – consumers, physicians, insurers, employers, and the government – to make cost-effective decisions in a competitive market environment. Key elements include: promoting competition among health care providers and insurers to lower health care prices; improving information on prices and outcomes to help patients and their physicians make more cost-effective decisions; shifting to new ways of paying for health care that promote efficiency, innovation, and better outcomes; and recognizing the appropriate and necessary role of regulation where markets are not workable.  [Note: contains copyrighted material].

[PDF format, 26 pages].

Domestic Food Assistance: Summary of Programs

Domestic Food Assistance: Summary of Programs.  Congressional Research Service. Randy Alison Aussenberg, Kirsten J. Colello, Kara Clifford Billings. Updated August 27, 2019

Over the years, Congress has authorized and the federal government has administered programs to provide food to the hungry and to other vulnerable populations in this country. This report offers a brief overview of hunger and food insecurity along with the related network of programs. The report is structured around three main tables that contain information about each program, including its authorizing language, administering agency, eligibility criteria, services provided, participation data, and funding information. In between the tables, contextual information about this policy area and program administration is provided that may assist Congress in tracking developments in domestic food assistance. This report provides a bird’s-eye view of domestic food assistance and can be used both to learn about the details of individual programs as well as compare and contrast features across programs. This report includes overview information for the U.S. Department of Agriculture’s Food and Nutrition Service (USDA-FNS) programs as well as nutrition programs administered by the Administration on Aging (AOA), within the U.S. Department of Health and Human Services’ Administration for Community Living (HHS-ACL).

[PDF format, 22 pages].

Healthy Vitality Age

Healthy Vitality Age. RAND Corporation. Sunil Patil et al. June 27, 2019.

The updated Vitality Age Calculator (VA.3) is an online tool that gives users a snapshot of their overall health based on lifestyle choices and clinical risk factors. While VA.3 compares the individual life expectancy (remaining years of life) to the average population life expectancy, this extension of the calculator, called Healthy Vitality Age, uses the concept of Health Adjusted Life Expectancy (HALE). HALE takes into account both mortality and morbidity by adjusting the life expectancy by the amount of time lived in less than perfect health. A Healthy Vitality Age higher than an actual age signals a lower-than-average number of years of healthy life remaining, with the difference between Healthy Vitality Age and actual age being equal to the estimated change in health adjusted life expectancy. This report documents the methodology of the Healthy Vitality Age extension to the VA.3 model and its limitations. [Note: contains copyrighted material].

[PDF format, 43 pages].

Medicare Primer

Medicare Primer. Congressional Research Service. Patricia A. Davis et al. Updated May 20, 2019

Medicare is a federal program that pays for covered health care services of qualified beneficiaries. It was established in 1965 under Title XVIII of the Social Security Act to provide health insurance to individuals 65 and older, and has been expanded over the years to include permanently disabled individuals under the age of 65. Medicare, which consists of four parts (AD), covers hospitalizations, physician services, prescription drugs, skilled nursing facility care, home health visits, and hospice care, among other services. Generally, individuals are eligible for Medicare if they or their spouse worked for at least 40 quarters in Medicare-covered employment, are 65 years old, and are a citizen or permanent resident of the United States. Individuals may also qualify for coverage if they are a younger person who cannot work because they have a medical condition that is expected to last at least one year or result in death, or have end-stage renal disease (permanent kidney failure requiring dialysis or transplant). The program is administered by the Centers for Medicare & Medicaid Services (CMS) within the Department of Health and Human Services (HHS) and by private entities that contract with CMS to provide claims processing, auditing, and quality oversight services.

[PDF format, 43 pages].

The National Institutes of Health (NIH): Background and Congressional Issues

The National Institutes of Health (NIH): Background and Congressional Issues. Congressional Research Service.  Judith A. Johnson, Kavya Sekar. April 19, 2019

The National Institutes of Health (NIH), under the Department of Health and Human Services (HHS), is the primary federal agency charged with performing and supporting biomedical and behavioral research. In FY2018, NIH used its over $34 billion budget to support more than 300,000 scientists and research personnel working at over 2,500 institutions across the United States and abroad, as well as to conduct biomedical and behavioral research and research training at its own facilities. The agency consists of the Office of the Director, in charge of overall policy and program coordination, and 27 institutes and centers, each of which focuses on particular diseases or research areas in human health. A broad range of research is funded through a highly competitive system of peer-reviewed grants and contracts.

[PDF format, 81 pages].