The long delay between the creation of new evidence for primary prevention by public health and widespread adoption into best practice by the health care system is well documented and a source of great frustration. The roots of this delay are complex and lie deep within the structure of the health care system. However, this problem also represents a major opportunity if root causes can be addressed and adoption of new evidence can be accelerated. The transformation of the health care system driven by the Affordable Care Act (ACA) has created such an opportunity.
For decades, the U.S. health care system has become increasingly costly without a corresponding increase in health care quality or outcomes. In response to this long-term trend and the multiple layers of stimulus provided by the ACA to improve coverage and introduce new payment models and care models, the system is now undergoing unprecedented change at the local, state, and nation levels. The expansion of insurance coverage has given millions of Americans access to the health care system. The shift from payment rewarding volume to new payment models based on value have restructured financial incentives. The widespread adoption of Triple Aim outcomes have focused attention on the need to improve population health. The public health sector—including the Centers for Disease Control and Prevention, public health departments, and the academic public health community—has a critical and timely opportunity to focus attention on improving population health through the broad application of prevention strategies and services to individuals and communities.