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Public Health Under the ACA Randall R. Bovbjerg, J.D. (BO - berg) The Urban Institute, Washington, DC Presentation to Public Health Systems Research Interest.

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Presentation on theme: "Public Health Under the ACA Randall R. Bovbjerg, J.D. (BO - berg) The Urban Institute, Washington, DC Presentation to Public Health Systems Research Interest."— Presentation transcript:

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 Bovbjerg, pub. hlth under ACA DC, 14 Feb. 2012

3 Roadmap My marching orders: Discuss recent brief, related implications for public health practice/policy -- 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) Bovbjerg, pub. hlth under ACA DC, 14 Feb. 2012

4 Bovbjerg, pub. hlth under ACA DC, 14 Feb 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

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 Bovbjerg, pub. hlth under ACA 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 PHs future: (i) defining paradigm, (ii) funding, (iii) evidence base, (iv) interrelations with others, (v) ability to communicate Bovbjerg, pub. hlth under ACA DC, 14 Feb. 2012

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

8 DC, 14 Feb Field Building: PHSR Bovbjerg, pub. hlth under ACA success data talent funding + + All true as far as it goes

9 Field Building: PHSR - 2 Research needs to be policy relevant (hence 2d R in PHSRR) It needs to be used for policy -- & its 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? Bovbjerg, pub. hlth under ACA DC, 14 Feb All true as far as it goes… but it only goes half way: success data talent funding + +

10 Bovbjerg, pub. hlth under ACA DC, 14 Feb 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


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