Post From Fast Facts
According to the Trust for America’s Health, an investment as little as $10 per person per year in evidenced-based, community prevention programs, such as those that increase physical activity, improve nutrition, and prevent tobacco use, could create health care savings of more than $16 billion annually within five years.
We already know that community development is a means for addressing social determinants of health and that coordination with the public health sector is critical to holistically improving health and well-being. However, the United States is not targeting enough of its health care spending on wellness and creating opportunities for health. The U.S. Centers for Disease Control and Prevention estimates that 86 percent of the nation’s health care costs are for care of chronic disease, many of which are preventable. Yet, only 3 percent of the government’s health budget is spent on public health and prevention measures and recent analysis suggests the public health share of total health spending is decreasing.
However, the Affordable Care Act has brought renewed interest in population health and wellness. The solution—state and local governments are exploring innovative ways to fund evidence-based efforts to prevent of chronic diseases, like Wellness Trusts.
A wellness trust is a funding pool raised to support prevention and wellness interventions that improve population health outcomes. Sources of funding can include public and/or private money. Growing interest in wellness trusts coincides with the current transformation of the health care system that moves care away from traditional fee-for-service payments to value-based, global payments for the care of population of patients. These new delivery and payment reform efforts are better aligned with community-based prevention and wellness efforts. Wellness trusts can complement community development financial vehicles to support health and well-being and supplement limited public resources for prevention.
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The Massachusetts Prevention and Wellness Trust was established by the Massachusetts legislature in 2012. It was the first state effort to use a wellness trust as a vehicle to make a large commitment to population-based health promotion efforts and was funded through a one-time assessment of acute hospitals and payers. The trust is a four-year, $60 million commitment to link health care and public health efforts, with the ultimate goal of improving health outcomes and controlling costs. More specifically, the trust states its goals as “reducing the rates of the most prevalent and preventable health conditions; increasing healthy behaviors; increasing the adoption of workplace-based wellness or health management programs that result in positive returns on investment for employees and employers; addressing health disparities; and developing a stronger evidence-base of effective prevention programming.”
Under the law, at least 75 percent of trust funds must be allocated for grantee programs and up to 10 percent can be used for worksite wellness initiatives. It is anticipated that savings from avoided medical care will be reinvested in the trust fund. To date, the trust supports nine partnerships across the state. Each partnership includes clinical organizations (hospitals and community health centers), community based organizations, and at least one municipality. In 2015 the partnerships began implementing evidence-based interventions targeting local needs. These partnerships are addressing the priority conditions of hypertension, elder fall prevention, childhood asthma, and tobacco use, as well as optional conditions including substance abuse, obesity, and diabetes.
Read more about Wellness Trusts on our Jargon Buster.