In addition to refocusing traditional public health activities, several states are integrating public health principles into broader policies, including coverage initiatives and new models of health care delivery. Many states, with support from the federal government, are attempting to transform primary care practices into medical homes (or patient-centered medical homes, PCMHs), which are based in part on public health principles. In addition to providing a regular source of care, medical homes emphasize care coordination, chronic care management, patient education and engagement, health promotion, and prevention.
Vermont, Minnesota, and Massachusetts are leaders in integrating public health into comprehensive health reform. All three states are promoting patient-centered medical homes by developing standards and payment methodologies to reimburse practices for the additional services provided in medical homes that are intended to reduce costs in the long term. These states are shifting from a focus on treating illness to a system that prioritizes prevention, supports healthy environments and lifestyles, improves access to preventive and primary care, and eliminates inequities in health status (see Box).1
Box: The Value of Integrating Public Health in Health Reform: A Transformed Health System for the United States in the 21st Century · Oriented toward health, rather than sickness, and able to address the known determinants of health – environmental, social, behavioral, and medical. · Comprehensive and capable of fostering health promotion and disease prevention at all levels, including individual, family, community, and country. · An amalgamation of the resources and knowledge of public health, health care, and all public and private sector entities that influence health outcomes at the community, state, and national levels. · Inclusive of the unique expertise of partners such as education and agricultural systems, as well as those not traditionally associated with health, such as transportation, industry, and energy, to assure that every American is served by a robust public health and health care system. · Capable of continuously measuring and improving the health of the public, while being fully accountable and transparent. · Built on key health system capabilities, including a standardized, integrated, individual, and public health information system; a sufficient and appropriate mix of health professionals; and flexible, sustainable financing. Source: Association of State and Territorial Health Officials, "A Transformed Health System for the United States in the 21st Century," August 2008. |
1. Association of State and Territorial Health Officials, "A Transformed Health System for the United States in the 21st Century," August 2008.
