Health commissioner sees wellness fund as 'future of health care'

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BOSTON >> About a year before funding is set to expire for a state trust fund aimed at preventing chronic health conditions, community health organizations and other stakeholders shared with lawmakers their success stories and concerns about what could happen when the program ends.

The Prevention and Wellness Trust Fund was established as part of a 2012 health care cost containment law and funded with $60 million over four years through an assessment on health insurers and large hospital systems. The fund allocated money to nine local partnerships that focus on pediatric asthma, hypertension, falls in older adults, and tobacco use.

"We will not successfully reach our goals of improving health outcomes and reducing costs, especially for those who are at risk of chronic disease, without building our public health capacity and linking it to our health care system in a coordinated way," Public Health Commissioner Monica Bharel told the Joint Committee on Public Health during an informational hearing Tuesday. "This is the future of health care, and this is why the Prevention and Wellness Trust Fund is so important."

With partnerships in Barnstable County, Berkshire County, Boston, Holyoke, Lynn, the MetroWest region, Quincy and Weymouth, New Bedford and Worcester, the fund's grantees cover approximately 15 percent of the population, according to the Department of Public Health.

Trust fund partnerships must have clinical, community-based and municipal components. The partnerships have resulted in more than 8,800 referrals from clinical sites to community organizations to address "needs of the whole person," according to the DPH.

Across the state, six YMCAs are participating in the trust fund as community partners, said Alliance of Massachusetts YMCAs Executive Director Peter Doliber.

Doliber said the YMCAs hope to see the fund continued beyond next year and expanded in scope.

"The Y's are very concerned that when these funds end, medical providers who will not have the incentive to work with the community providers will stop making referrals to them," he told the committee. "This would hurt everyone involved."

After a capacity building period, 2015 was the first full year of implementation for Prevention and Wellness Trust Fund programs, according to a DPH report to the Legislature in January of this year.

Funding is slated to sunset at the end of June 2017. The legislative report concluded that the four-year time frame "presented opportunities and challenges," allowing a quick response to a public health need.

"However, the impact of the model of linking clinical and community care and focusing on 'upstream' prevention efforts to promote health will not be fully demonstrated by June of 2017, and the opportunity for deeper and more sustained impact is still in front of us," the report said.

An independent evaluation of the Prevention and Wellness Trust Fund is due to the Legislature in January of 2017.

Rebekah Gewirtz, executive director of the Massachusetts Public Health Association, said that report will contain the data and figures needed to truly assess the outcomes of the funded programs and partnerships.

"Even from what's happening now, we know what's happening now is working," she told the News Service.


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