By Richard Asinof
By Richard Asinof
Karen Voci, the executive director of the Harvard Pilgrim Foundation, recently received the Innovator’s Award from the Foundation for Healthy Communities for her efforts to reduce childhood obesity.
Providence Business News asked Voci, an East Greenwich resident who previously worked for the Rhode Island Foundation, to share her insights about how investments in prevention efforts improve the quality of health care and reduce costs.
PBN: You were recently honored with an Innovator’s Award for your work with the CATCH Kids Club on efforts to reduce childhood obesity. What was the focus of that program? Why did it work?
VOCI: CATCH, or the Coordinated Approach to Child Health, is an evidence-based program that trains and supports school and after-school staff to change environments for children and support them to “eat better and move more.”
By bringing CATCH training to New Hampshire and helping after-school programs to start CATCH Kids Clubs, we have helped staff to increase healthier food options, limit unhealthy choices, increase physical activity and dramatically reduce screen time.
The program works because it changes the culture of the program - rather than focusing on the behavior of individual children.
PBN: The number of children in poverty is on the rise, according to the latest analysis of U.S. Census Bureau data. In the long term, what are the health care consequences? Does that speak to the need to expand Medicaid programs that provide health insurance coverage to children and families?
VOCI: The latest data shows that almost one in five of Rhode Island's children are living in poverty. Research also indicates that children in poverty, especially those who experience poverty in early childhood and for extended periods of time, are more likely to have health and behavioral problems. These are problems which can affect the overall cost of health care.
Fortunately, for children in Rhode Island, the state’s policy makers have made children's health insurance coverage a priority through the nationally recognized RIte Care program. Children with comprehensive health insurance coverage like RIte Care are more likely to have regular doctor check-ups, be screened for developmental milestones, and receive medical care for illnesses and chronic conditions.
Continued support for Rite Care is a wise investment for the state due to the positive health outcomes it has achieved. We should build on the success of this program as we implement the Affordable Care Act. In addition to medical care, it is also important that we ensure that children in all communities have access to nutritious foods, fresh fruits and vegetables and safe places to get outside and play.
PBN: As executive director of the Harvard Pilgrim Health Care Foundation, what do you see as the most critical interventions and investments that are needed to improve the quality of health care today?
VOCI: The foundation's focus is on prevention – a strategy that isn't necessarily about diet and exercise for individuals, but is more focused on making communities places where healthy food and physical activity are the easier and more affordable options.
It’s about where we locate stores and schools so that more people can walk or bike, to be sure there are usable sidewalks and places for gardens and farmers markets.
By working to improve our communities, we are ultimately improving the health of local residents – and consequentially improving the quality and cost of health care for all Rhode Island residents.
PBN: What do you see as the responsibility of the business community regarding improving health care? How can they become a partner in your efforts?
VOCI: Businesses are very important partners because they can support healthier environments in the workplace, which then support healthier choices by their employees at home and as parents.
Healthier employees mean less health care costs for their employers. At the same time, they are a critical piece of our communities in terms of investments in infrastructure and choices for consumers. Where businesses are located, how they design their facilities and what they offer as products can make communities more or less livable and/or “walkable.” Business has a big role to play in chronic disease prevention – and it is one that many are starting to take seriously – from small offices to larger retailers.
PBN: Based upon the experience in Massachusetts, with its own version of a health insurance benefits exchange, how important is it for states to set up an online marketplace for health insurance under the federal health care reform law?
VOCI: As a mandated requirement of the Affordable Care Act, setting up an online health insurance exchange is an important task for all states to complete by 2014. Perhaps even more important is doing it well so that they create an effective and open marketplace for individuals and small businesses to purchase health insurance.
Our experience in Massachusetts, as well as our involvement in the efforts taking place in Maine and New Hampshire to set up exchanges, leads us to understand the important decisions that policy makers must resolve in developing an exchange.
There are important lessons to be taken from states like Massachusetts and Utah that have operating exchanges, but each state faces unique challenges that need to be addressed in order to form an effective exchange marketplace.
The process is definitely challenging, but long-term it will be a positive for consumers if it increases access to affordable and quality health care coverage.