Altarum Institute’s Center for Sustainable Health Spending (CSHS) is engaged in a multiyear research program to investigate spending on prevention and the value obtained from such investments.

The program has addressed the following issues:

  • What does the United States spend on prevention, and how does that compare with spending on treatment?
  • What are the tradeoffs between spending on prevention and treatment? Should resources be shifted from treatment to prevention? How does prevention spending affect the effectiveness and cost-effectiveness of treatment spending and vice versa? (This work was funded in part by a grant from the National Heart, Lung, and Blood Institute.)
  • How can we establish the value of investments in primary prevention, including investments in the social determinants of health, to health outcomes and health care costs? How does that value differ from the perspectives of the various stakeholders (e.g., government, the business community, providers, payers) that might support such investments? (This work, which is being funded by a series of grants from the Robert Wood Johnson Foundation, is summarized in this fact sheet. Further details can be found in this report.)

Publications and Presentations on Prevention by Altarum CSHS Staff

Peer-Reviewed Publications

  • Miller G, Roehrig C, Russo P. A framework for assessing the value of investments in nonclinical prevention. Prev Chronic Dis. December 10, 2015;12:150363. doi:10.5888/pcd12.150363.
  • Roehrig C, Daly M. Prevalence trends for three common medical conditions: treated and untreated. Health Aff (Millwood). 2015;34(8):1320–1323. doi:10.1377/hlthaff.2015.0283.
  • Miller G, Daly M, Roehrig C. Tradeoffs between  cardiovascular disease prevention, treatment, and research. Health Care Manag Sci. June 2013;16(2):87–100. doi:10.1007/s10729-012-9215-x.
  • Miller G, Cohen J, Roehrig C. Cost-effectiveness of cardiovascular disease spending. J Am Coll Cardiol. November 13, 2012;60(20):2123–2124. doi:10.1016/j.jacc.2012.02.095.
  • Miller G, Hughes-Cromwick P, Roehrig, C. National spending on cardiovascular disease, 1996–2008. J Am Coll Cardiol. November 1, 2011;58(19):2017–2019. doi:10.1016/j.jacc.2011.08.018.
  • Miller G, Roehrig C, Hughes-Cromwick P, Turner A. What is currently spent on prevention as compared to treatment? In: Faust HS, Menzel PT, eds. Prevention vs. Treatment: What’s the Right Balance? New York, NY: Oxford University Press; December 2011. doi:10.1093/acprof:oso/9780199837373.001.0001.
  • Miller G, Roehrig C, Hughes-Cromwick P, Lake C. Quantifying national spending on wellness and prevention. Adv Health Econ Health Serv Res. 2008;19:1–24.

Conference Presentations

  • Miller G, Roehrig C. Assessing the Value of Investments in Non-Clinical Primary Prevention. Presented at INFORMS Healthcare 2015, Nashville, TN, July 2015.
  • Miller G, Roehrig C. Assessing the Benefits and Costs of Prevention from Multiple Stakeholder Perspectives. Presented at the national meeting of INFORMS, San Francisco, CA, November 2014.
  • Miller G, Roehrig C. Assessing the Benefits and Costs of Prevention from Multiple Stakeholder Perspectives. Presented at the AcademyHealth 2014 Annual Research Meeting, San Diego, CA, June 2014.
  • Miller G. Valuing Investments in Nonclinical Prevention. Presented at a seminar series of the University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, January 2014.
  • Miller G. Investments in Prevention: Countering Myths and Resolving Paradoxes. Presented at a seminar series of the University of Michigan Center for Healthcare Engineering and Patient Safety, Ann Arbor, MI, December 2013.
  • Miller G. Exploring the Relative Cost-Effectiveness of Community-Based Versus Clinical Preventive Services. Presented at INFORMS Healthcare conference, Chicago, IL, June 2013.
  • Miller G, Roehrig C. What Is the Right Balance between Prevention and Treatment? Presented at the national meeting of INFORMS, Phoenix, AZ, October 2012.
  • Miller G. Modeling the Tradeoffs Between Prevention and Treatment Spending: An Application to Cardiovascular Disease. Presented at the AcademyHealth Annual Research Meeting, Orlando, FL, June 2012.
  • Miller G. Evidence for the Economic Efficiency of Wellness Initiatives. Presented at Charting the Future of Wellness, University of Michigan School of Public Health, Ann Arbor, MI, May 2012.
  • Miller G, Daly M, Roehrig C. Modeling the Cardiovascular Disease Prevention-Treatment Tradeoff. Presented at the national meeting of INFORMS, Charlotte, NC, November 2011.
  • Miller G, Roehrig C, Hughes-Cromwick P, Turner A. What Do We Really Spend on Prevention in the US, and What Is Missing from Our Calculations? Presented at the INFORMS Healthcare Conference, Montreal, Canada, June 2011.
  • Miller G, Roehrig C, Hughes-Cromwick P, Turner A. What Do We Really Spend on Prevention in the US, and What Is Missing from our Calculations? Presented at Preventive Medicine 2011, San Antonio, TX, February 2011.
  • Miller G, Daly M, Roehrig C. Modeling the Treatment-Prevention Tradeoff. Presented at the Centers for Disease Control and Prevention conference Modeling for Public Health Action: From Epidemiology to Operations, Atlanta, GA, December 2010.
  • Miller G, Roehrig C, Daly M, Hughes-Cromwick P. Modeling the Treatment-Prevention Tradeoff. Presented at the 3rd Biennial Conference of the American Society of Health Economists, Ithaca, NY, June 2010.
  • Miller G, Daly M, Roehrig C. Modeling the Treatment-Prevention Tradeoff. Presented at the national meeting of INFORMS, San Diego, CA, October 2009.
  • Miller G, Roehrig C, Hughes-Cromwick P. Quantifying National Spending on Wellness and Prevention. Presented at the conference Beyond Health Insurance: Public Policy to Improve Health, College of Medicine and Institute of Government and Public Affairs, University of Illinois at Chicago, Chicago, IL, November 2007.

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George Miller

Altarum Institute Fellow

George.Miller@altarum.org

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