Why Behavioral and Environmental Interventions are Needed to Improve Health at Lower Cost

This study used a dynamic simulation model of the U.S. health system to test three proposed strategies to reduce deaths and improve the cost-effectiveness of interventions: (1) expanding health insurance coverage; (2) delivering better preventive and chronic care; and (3) protecting health by enabling healthier behavior and improving environmental conditions.

Researchers found that each alone could save lives and provide good economic value, but they are likely to be more effective in combination. Although coverage and care save lives quickly, they tend to increase costs. The impact of protection grows more gradually, but it is a critical ingredient over time for lowering both the number of deaths and reducing costs. Only protection slows the growth in the prevalence of disease and injury, and thereby alleviates rather than exacerbates demand on limited primary care capacity. When added to a simulated scenario with coverage and care, protection could save 90 percent more lives and reduce costs by 30 percent in year 10; by year 25, that same investment in protection could save about 140 percent more lives and reduce costs by 62 percent.

This study was not funded by the Robert Wood Johnson Foundation, but is being made available as an additional resource on this topic.