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Clinically based preventive care critical to reform

As the health care reform debate roared through town hall meetings and radio airwaves, a more fundamental revolution quietly took place -- the paradigm shift from reactive to proactive health care. The American ingenuity that brought us airplanes, artificial hearts and, yes, even Astroturf is discovering ways to help people live longer, healthier lives.

Like most innovation, the preventive health care movement is driven by necessity. The United States can no longer afford a system where 70 percent of deaths and nearly 80 percent of health care costs stem from the same preventable chronic conditions. At this crossroads in health policy, we have a rare opportunity to nurture a movement that can save hundreds of billions, make our workforce more competitive and improve the quality of our lives.

Preventive health care is based on a simple premise -- saving money by keeping people healthy and treating chronic illnesses before they progress. Clinically based preventive health care moves beyond wellness programs to identify risks and recommend actions to avert those risks; detect diseases in the earliest stages when treatments are more effective; and slow or reverse the progression of disease once identified.

At each stage of the prevention continuum, technology can reinvent the house call, efficiently connecting people with health care professionals for education, individual action plans and one-on-one coaching. Simple blood tests combined with health history and lifestyle questionnaires can identify the risk factors for many chronic conditions. Identifying top risks can provide lifesaving early detection while avoiding the excessive costs associated with unnecessary screenings.

The biggest hurdle may be motivating Americans to make healthy lifestyle changes, but to achieve results we have to do more than screen and identify, we have to change behaviors. We all know we should choose the apple instead of the donut but habits are deeply ingrained.

Preventive health care entrepreneurs are developing creative ways to motivate people to make healthier choices. Monetary incentives, such as reduced health insurance co-payments for participants, have shown promise in improving success rates. Coaching and frequent contact with health care professionals can also achieve positive results.

Not every program will succeed. As pointed out in a recent CBO analysis, some early wellness efforts offset cost savings with excessive health screenings. As in any burgeoning industry, effective programs exist beside ineffectual window dressing. Rest assured that free market dynamics will prevail. Industry leaders learn each day from outcomes data and use sophisticated ROI models to weigh costs and benefits. As the industry matures, the market will reward clinically sound programs that deliver results.

The World Health Organization estimates chronic conditions will become the world's leading cause of disability by 2020. If we harness some of the passion surrounding health care reform and direct it toward preventive health care, we can change that prognosis. By employing clinically-proven methods and establishing a culture of prevention in our schools, workplaces and homes, our nation will begin to see results--results that will improve every aspect of our lives and ease a major drain on our economy.

Christopher Fey is chairman and CEO and Dr. Boyd D. Lyles Jr. chief medical officer of U.S. Preventive Medicine Inc.