Preventive programs could save millions in U.S. health care costs, report finds

A new report from the not-for-profit health advocacy group Trust for America’s Health finds that an investment of $10 per person annually in community-based disease prevention programs to increase physical activity, improve nutrition, and prevent smoking could save the United States $16billion in medical costs annually within five years. The report, Prevention for a Healthier America, is based on a savings estimate model developed by researchers at the Urban Institute-a nonpartisan social and economic research organization-and a review of 84 evidence-based studies conducted by the New York Academy of Medicine. Focusing on disease prevention programs that target communities or at-risk populations within communities but do not require medical care, the researchers find that many community-based prevention programs that effectively lower rates of diseases that are directly related to physical activity, nutrition, and smoking cost less than $10 per person. Citing evidence that such community-based interventions have the potential to reduce the prevalence of type 2 diabetes and high blood pressure by 5% within two years, and decrease rates of heart and kidney disease and stroke by 5% within five years, the researchers project that the nation would reap a return of $5.60 for every $1 invested in community programs, based on 2004 dollars. Of the $16 billion in annual potential medical cost savings, the report suggests that the Medicare program could save $5.2 billion, the Medicaid program could save $1.9 billion, and private insurers could save more than $9 billion. The authors clarify, meanwhile, that potential savings estimates vary by state. For example, the report indicates that California would save roughly $1.7 billion within five years with a $4.80 return on investment (ROI) for each $1 spent on prevention programs; New York would save $1.3 billion with an ROI of $7 for each $1 invested; and Texas would save $1 billion with an ROI of $4.70 for each $1 spent. Although the report calculates only medical cost savings, the researchers note that "significant gains…could be achieved in worker productivity and enhanced quality of life." Commenting on the findings, the senior vice president and director of the health group at the Robert Wood Johnson Foundation-which partially funded the study-says "our nation needs a sustained investment in disease prevention programs that keep people from becoming sick, not just more treatment for those who are already ill" (Trust for America’s Health report (, 7/17; Trust for America’s Health release (, 7/17; Greenwell, Washington Post (, 7/18 [registration required]). (SOURCE: Advisory Board Daily Briefing,, July 18, 2008)