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Public Health Under the ACA

Public Health Under the ACA. Randall R. Bovbjerg, J.D. (BO - berg) The Urban Institute, † Washington, DC. Presentation to Public Health Systems Research Interest Group Breakfast, “Research Matters: Evidence to Inform Public Health Policy and Practice,” NHPC, 14 February 2012.

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Public Health Under the ACA

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  1. Public Health Under the ACA Randall R. Bovbjerg, J.D. (BO - berg) The Urban Institute,†Washington, DC Presentation to Public Health Systems Research Interest Group Breakfast, “Research Matters: Evidence to Inform Public Health Policy and Practice,” NHPC, 14 February 2012 †standard disclaimer applies

  2. Happy Va ne's , PHSR! DC, 14 Feb. 2012

  3. Roadmap • My marching orders: “Discuss recent brief, related implications for public health practice/policy” -- email from organizer, January 25, 2012 • My plan for next 12 minutes: • Précis of brief • Changes in ACA era • Field building for PHSR (aka PHSSR, but needs to be PHSRRFF) DC, 14 Feb. 2012

  4. Brief Randall R. Bovbjerg, Barbara A. Ormond, and Timothy A. Waidmann, “What Directions for Public Health under the Affordable Care Act?” Washington, DC: Urban Institute issue brief for RWJF, Nov. 2011 http://www.urban.org/publications/412441.html DC, 14 Feb. 2012

  5. Précis of Brief - 1 • ACA is a signal accomplishment for PH • Great excitement at single mention by Clintons • Prevention and PH are high priorities of ACA • Thumbnail of the ACA and public health • Insurance expansion • Public health • Coverage even includes public health/prevention • Vulnerabilities and challenges • History of funding • Intrinsic challenges of promoting population health DC, 14 Feb. 2012

  6. Précis of Brief - 2 • Challenges and opportunities • Priorities • Partnerships • Promotion • Concluding discussion • 2 views on top issues: (a) health threats (e.g., obesity) vs. (b) needed improvements in PH operations • 5 keys for PH’s future: (i) defining paradigm, (ii) funding, (iii) evidence base, (iv) interrelations with others, (v) ability to communicate DC, 14 Feb. 2012

  7. Paradigm Shifts? Traditional Future Health Partnerships Evidence-based Prioritization Funding earned Organized functionally • Public health vs. clinical • Public vs. private • Profession-driven • Priorities (galore) • Funding pressured • Silo-ed categorically … all a work in progress DC, 14 Feb. 2012

  8. Field Building: PHSR data + talent + funding success All true as far as it goes DC, 14 Feb. 2012

  9. Field Building: PHSR - 2 All true as far as it goes • Research needs to be policy relevant (hence 2d R in PHSRR) • It needs to be used for policy -- & it’s not self-effectuating • It needs to promote further funding, external or internal (hence PHSRRFF) • Query: what evidence should come from retrospective project research, what from routine performance measurement? … but it only goes half way: data + talent + funding success DC, 14 Feb. 2012

  10. Final Thought Perhaps. But how will we get health into the home in the 21st century? Source, Wash. Post Outlook sect., p.1, Sunday, 31 May 2009 DC, 14 Feb. 2012

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