Evan Ross

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	The Department of Health and Human Services (HHS) has partnered with CVS Health to integrate the Healthfinder.gov app into CVS' web space under the name 

 was the first government website designed to share health information and to improve health literacy with the public. Myhealthfinder will take health information further to the public.

	The partnership will put “lifesaving information about preventative services into the hands of millions…where they are already looking for it” said Karen DeSalvo, M.D., M.P.H., M.Sc., Acting Assistant Secretary for Health (ASH) and National Coordinator for Health Information Technology (ONC) in a 

	Consumers visiting myhealthfinder can enter their age, gender, and a few other basic questions to find out what preventative steps they should take in order to maintain their health. The results include tests and doctor visits the consumer should plan. Many of the services suggested by myhealthfinder are available at CVS’s MinuteClinic locations.

Payer/provider collaboration is a key to improving care

	The partnership is designed to make the public aware of preventative healthcare. In a 

 announcing the partnership, Andrew Sussman, M.D., MinuteClinic president and executive vice president/associate chief medical officer, CVS Health, said "We know that prevention is key to helping families stay healthy, so we are pleased to work with the U.S. Department of Health and Human Services to give people easy access to more information about the preventive services clinically recommended for them."

	Since the passage of the Affordable Care Act, preventative care has become a major priority for patients and health plans.

	CVS is the first private company to collaborate with HHS to promote myhealthfinder. HHS has made a “free, publically available application programming interface (API)” ready for third-party developers to use in other apps, websites or wearable devices.

Articles

CVS Health is integrating HHS' Healthfinder.gov app into its web space under the name myHealthFinder.

HHS partners with CVS Health to promote Healthfinder.gov

	Even though the Affordable Care Act (ACA) eliminated cost sharing for breast, cervical and colorectal (CRC) cancer screening for many, the percentage of adults undergoing screenings  has not increased and, in some cases, it has actually decreased, according to a new report by the Centers for Disease Control (CDC).

 sets targets for cancer screening tests based on the most recent U.S. Preventative Services Task Force (USPSTF) guidelines. The CDC used the 2013 National Health Interview Survey (NHIS), the most recent available, to examine the rate of breast, cervical, and CRC screening.  Compared to the 2010 results, progress was “not observed” in 2013.

Study finds PCMHs improve cancer screening rates

	According to the survey, mammography and CRC tests remained fairly stable since 2010, while Pap test use declined.

	There seemed to be two dividing lines that may explain the lower screening rates. First, those without health insurance or those without a regular healthcare provider were more likely than those with insurance to skip screenings. Second, women in higher income and education brackets were more likely than women in lower brackets to have been screened for breast and cervical cancer.

Kaiser’s prostate cancer care program reports improvements

	The survey revealed that the percentage of women in the highest education and income brackets exceeded the target for breast cancer screening; the percentage of women with privately-held insurance was also on target. The percentage of people aged 65-75 screened for CRC was near the target value set by the USPSTF.

	The NHIS is an annual survey of a “nationally representative sample of the civilian, non-institutionalized population.” From the 2013 survey, the response rate for adults was 61.2 percent, and this data was used to examine recent screenings of the above cancers.

	The USPSTF recommends breast cancer screenings for women between the ages of 50 and 74 every two years, Pap tests for women between the ages of 21 and 65 every three years, and fecal occult blood tests (FOBT) every year, sigmoidoscopy and FOBT every five years or colonoscopy tests every 10 years for those between the ages of 50 and 75.

Even though cancer screenings have become more available because of the Affordable Care Act, the percentage of adults getting certain cancer screenings has not increased significantly since 2010.

Despite ACA, Americans still skip cancer screenings

	Provisions of the Affordable Care Act (ACA) will cost $142 billion less-or 11%-over the 2016–2025 period than originally estimated by the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT).

	According to revisions released in March from the CBO, the reduction is based on two primary factors: a slower growth of private health insurance premiums; and differing sources and numbers of people gaining insurance through the ACA.

Health expenditures slow to lowest growth rate in 53 years

	In January, the original estimated cost of the ACA was expected to be more than $7.6 trillion from 2016 to 2025. New estimates place that number at $7.2 trillion.

	Factors that led to lower overall budget projections stemming from the number and type of health insurance gained under the ACA include:

			A lower estimate of the total number of people with employment-based coverage;

			An increase in the estimate of workers employed by businesses with 1,000 or more employees;

			A decrease in the estimate of the number of people who had no health insurance at all; and

			Higher Medicaid enrollment before 2014 than previously estimated.

	
	NEXT:  Other factors that led to lower estimates

	The CBO and the Joint Committee on Taxation (JCT) lowered their estimates of private health insurance premiums for the 2016 – 2025 period based on new information on national health expenditures. “Spending by private health insurers on health care and administration rose less in 2013 (the most recent year for which data was available) than in preceding years and by much less than the agencies had expected for 2013” concluded the CBO and JCT, the result of the continuing trend of “relatively” slow growth in healthcare spending.

	After removing the effects of overall inflation and adjusting for population changes, the CBO and JCT estimated that private health insurance spending per enrollee only grew an average of 1.8% per year between 2006 - 2013, compared to the rate of 5% per year between 1998 - 2005. Estimates of spending-per-enrollee are expected to grow 2.2% between 2014 - 2018 and 3.1% between 2019 - 2025.

	The slower rate of growth in premiums is also expected to impact the excise tax on “Cadillac plans.” Fewer plans will have to pay the “Cadillac tax,” which will decrease the projected revenues by more than 40%.

	The lower rate of private health insurance cost affects the amount of money the government needs for healthcare exchange subsidies. In 2010, the CBO predicted that health insurance subsidies would average $5,200 per person in 2015. The new estimate puts hat total at $3,960, a 20% reduction.

	Medicaid costs are expected to be $847 billion in the next decade, down 8% from the January estimate.

Provisions of the Affordable Care Act will cost $142 billion less over the 2016–2025 period than originally estimated by government agencies, due to slower premium growth and changes in enrollment sources.

ACA provisions will cost $142 billion less than predicted

	In an effort to compensate providers based on the quality of care, 

 has shifted 11 million individual, employer-sponsored, Medicare and Medicaid plan participants into value-based programs.

	The nation’s largest insurer currently contracts with about 520 accountable care organizations (ACOs), and it has announced plans to contract with 250 new ACOs in 2015.

	“These deeper, more collaborative relationships” with hospitals, physicians and providers will help UnitedHealthcare realize its goal of increasing the value and quality of care provided to their customers, the company said in a press release.

Top stakeholders form task force to accelerate shift to value-based care

	“UnitedHealthcare is building more collaborative relationships with more care providers to ensure our plan participants have access to higher-quality, cost-effective care,” said Dan Rosenthal, president of UnitedHealthcare Networks.

	Care providers seem receptive to UnitedHealthcare’s mission: The insurer has nearly tripled the payments to physicians and hospitals tied to value-based care initiatives. In 2015, those payments are expected to increase by 20% to $43 billion and, by 2018, payments are expected to reach $65 billion.

	Instead of focusing on isolated individual health problems, providers are given additional support to manage population health, according to the insurer. Support from UnitedHealthcare includes IT tools that can lower costs and provide immediate, actionable data, according to the company.

	Its current ACOs are improving patient health and lowering costs by keeping all aspects of a patient’s healthcare connected and in one place; rewarding physicians that encourage preventative care; and transitioning care providers into a model that pays based on the total value to the patient instead of a model that only rewards “fee-for-service.”

	“Deeper, more integrated relationships with health plans like UnitedHealthcare are making a tangible impact on patient’s health,” said Simon Schwartz, M.D., president and chief executive officer of New York-based 

, which began an ACO arrangement with UnitedHealthcare in 2012 to serve its 13,000 plan participants.

Plans, providers must collaborate for value-based payment models to succeed

More than 11 million UnitedHealthcare members are enrolled in accountable care organizations (ACOs), and the nation's top insurer plans to contract with 250 more ACOs in 2015.

UnitedHealthcare enrolls 11 million in accountable care programs

A low-fat, plant-based vegan diet may help obese children lower their risk of heart disease as compared to the American Heart Association (AHA)’s recommended diet, according to a new study from 

 took place over four weeks and was overseen by Michael Macknin, M.D., a staff pediatrician at Cleveland Clinic Children’s. The 28 obese children in the study were between the ages of 9 and 18; all had high cholesterol, and all had one parent that also followed the diet. Results showed that a plant-based diet resulted in improvements in obese children’s weight, blood pressure, body mass index, cholesterol levels, insulin sensitivity and high-sensitivity C-reactive.

	The diet consisted of vegan plants and whole grains, with limited avocado and nuts, no added fat and no animal products. After four weeks, the children in the study had significant improvements in nine measures: BMI, systolic blood pressure, weight, mid-arm circumference, total cholesterol, low-density lipoprotein (LDL) cholesterol, insulin, myeloperoxidase and high-sensitivity C-reactive protein. The latter two are common markers of heart disease. They also reduced their consumption of animal proteins, calories from fat and saturated fat.

 also saw positive results, but in lesser quantities. The AHA diet consisted of fruits, vegetables, whole grains and non-whole grains, limited sodium, low-fat dairy, selected plant oils and lean meat and fish in moderation. Children on the AHA diet had improvements in weight, waist circumference, mid-arm circumference and myeloperoxidase.

	“We’ve known that plant-based diets are beneficial in adults in preventing and possibly reversing heart disease,” said Macknin. “This study shows that the same may be true in children, too.”

Weighing the benefits of anti-obesity drugs

	Obese children are at a higher risk of cardiovascular disease, which can continue into adulthood. Therefore, it is important to start to get children to eat healthier at a younger age.

	“If we can see such significant improvements in a short four-week study, imagine the potential for improving long-term health into adulthood…” said Macknin.

	The Cleveland Clinic reported that participants had difficulty finding and purchasing the necessary food for a plant-based vegan diet. “We know that plant-based diets are effective, but if they are to be widely used, we need to make access…easier and more affordable,” Macknin noted.

A low-fat plant-based vegan diet may help obese children lower their risk of heart disease, finds a new study from Cleveland Clinic.

A low-fat, plant-based diet may help obese children lower heart disease risk

	Approximately one-third of American adults use complementary medicine practices or products including mind practices, body practices or natural products, according to a 

 The findings are similar to NHIS survey results from 2002 and 2007 that showed a steady market for complementary medicine.

	Survey results show that, out of a total sample of 34,525 adults and 10,218 children between four and 17 years of age, 33.2% of adults and 11.6% of children use complementary health approaches. Mind and body practices include chiropractic manipulation, massage, meditation and yoga, and natural products include ginseng, melatonin, echinacea and fish oils.

	The NHIS first included a section on complementary medicine and integrative health approaches in 2002. In 2007, the first year in which children were included in the survey, 12% of respondents reported using complementary health approaches.

	Mind and body practices are described as those that “improve health and well-being or help manage symptoms of health problems.” For adults, yoga is the 

, with 9.5% of respondents reporting that they practice it, up from 6.1% in 2002. Another 8.4% of respondents reported practicing chiropractic/osteopathic manipulation, while 8% report using meditation. In addition,  6.9% reported using massage therapy, down from 8.3% in 2007.

	Other forms of mind and body practices used by respondents include guided imagery, progressive relaxation and acupuncture.

	The survey found that the most popular natural product for adults is 

, with 7.8% of adults reporting utilization. Fish oil use has shown a steady rise since 2002, when only 2.2% of respondents reported using it. 

	The other top natural products in the survey were glucosamine and/or chondroitin (2.6%), probiotics/prebiotics (1.6%) and melatonin (1.3%). Echinacea, garlic supplements, ginseng and ginkgo biloba were all  used by less that 1% of those surveyed.

	Fatty oils and fish oils are also the number one natural product used by children, but all natural products are used at much lower rates than for adults, with 1.1% of children using fatty or fish oils, 0.7% using melatonin, 0.5% using probiotics/prebiotics and 0.4% using Echinacea. 

Results from a national survey show that one-third of American adults use complementary medicine practices or products, including yoga, fish oils, massage therapy and ginseng.