Recipients of AcademyHealth’s Presidential Scholarship for the AcademyHealth Institute on Advocacy and Public Policy were invited to blog about their experiences during the 2013 National Health Policy Conference. The following post is written by Catherine Wolff, a health policy researcher at The University of Pennsylvania. At the National Health Policy Conference last week, AcademyHealth’s Public Health Systems Research (PHSR) Interest Group hosted a breakfast meeting with panelists Andrew Rein, associate director for policy at the U.S. Centers for Disease Control and Prevention (CDC), and Natasha Coulouris, senior public health adviser at the U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA), to discuss how the Affordable Care Act (ACA) has created opportunities for researchers and public health officials to improve population health. Rein and Coulouris focused their comments on how the ACA is driving opportunities for public health and primary care systems to integrate, necessitating the alignment of priorities, interventions, services, and funding between the two fields. On the heels of the IOM report "Primary Care and Public Health: Exploring Integration to Improve Population Health," the CDC and HRSA are looking to implement the proposed strategies in support of systems integration. The push for increased coordination of public health and primary care creates exciting opportunities for high-impact research. According to Rein, the CDC in particular is interested in the development of methods that combine clinical and public health data to investigate issues relevant to both fields, such as chronic disease management. They’d also like to know how service programs can be linked between the two fields; for instance, evaluating the feasibility of using public health providers to augment primary care services, and to better incorporate prevention into those services. The development of linked delivery systems also necessitates exploration into how private payers can be incorporated to fund services provided by public health practitioners. Coulouris explained that HRSA is especially attentive to workforce issues, given the large increase in the insured population expected in 2014. In particular, the organization would like to know how to clearly enumerate the workforce, organize inter-professional teams of care, ensure that providers are ready for an increase in patients, and make sure that patients can get the care they need. For the latter goal, HRSA is interested in seeing how the existing public health infrastructure, which is designed to rapidly reach entire communities during public health emergencies and which also retains expertise in connecting to hard-to-reach populations can be deployed to connect patients to providers and educate the community about insurance options and preventive care services. Additional high-priority areas noted by both panelists were issues of accountability and capacity, and determining how to structure laws and regulations so that both public health and clinical care systems can work toward the same goals in a collaborative fashion. Research identifying effective and ineffective policies will be valuable in addressing these questions. Furthermore, Rein and Coulouris emphasized that one of the most important and pressing needs for their respective agencies was evidence to help them make the case for funding population health programs, before the momentum behind the ACA fades. Each made an urgent request for examples of programs showing costs savings and improved health outcomes, as well as proof-of-concept models for sustainable funding of population health programs. Given the national energy surrounding health care innovation and impending changes in delivery and payment systems, the need for research to guide policy is immediate. This is especially true in population health, where it can be difficult to assess the true benefits of programs serving large, diverse communities. However, as described during this session, there are also many opportunities for researchers and policymakers to focus on important questions that can immediately be translated to improve the health of the nation.  

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