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Tracy Carver, MPA, is a program director with HealthInsight. She has worked with HealthInsight Oregon (formerly Acumentra Health) since 2011. In October, Ms. Carver began serving as program director overseeing HealthInsight’s diabetes prevention program related grant activities. Previously, she managed the Centers for Medicare & Medicaid Services (CMS) Everyone with Diabetes Counts initiative and the Integrating Evidence-based Self-Management Education into Patient Care Special Innovation Project in Oregon. Tracy has served as a leader in companywide physician office design and operations activities and for several proposal teams. Before joining HealthInsight, Tracy worked for the Oregon Health Authority coordinating initiatives focused on community-based approaches to self-management, health literacy, disparities and reducing the burden of chronic disease. She has more over a decade of experience leading innovative quality improvement and population health initiatives. She holds a Master of Public Administration degree from Portland State University.

The Power of Prevention

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A few years ago, I watched as a childhood friend was diagnosed with diabetes and then multiple other related co-morbidities in rapid succession. It has affected every aspect of her life and was caught much later than it should have been, exasperated by years of lacking access to health insurance and preventative care. As her friend, I knew on some level for that she was at risk of developing a chronic condition and did my best to support her, but was unsure how to help her change her circumstances. I’ve worked in a health related field for most of my career, but this experience has further driven me to want to advance prevention and understand what people truly need to stay healthy.

An alarming 1 out of 3 adults has pre-diabetes. And of those, 15-30 percent will develop Type 2 diabetes within five years. Not only is diabetes emotionally, physically and financially costly for individuals and their families, it accounts for 23 percent of total health care costs annually in the United States and is highly associated with heart disease, which is the leading cause of death worldwide.

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Changing the Conversation from Health Care to Health

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I was excited to hear Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention (CDC), speak at this year's Centers for Medicare & Medicaid Services (CMS) Quality Conference about the importance of moving "upstream" and strengthening the relationship between community-based prevention services and health care. This is a topic near and dear to my heart, as I started my career working in public health to help communities improve the systems that support community health and prevention. Now that I work in health care quality improvement, I see daily the health care community's challenges and opportunities in not only providing good health care, but helping people achieve health.

Most of us who work in health have learned that there are significant limitations to what the health care system can achieve alone. Our systems of care must change to meet the growing burden of chronic disease.

Cardiovascular diseases, pre-diabetes and diabetes are at a record high. According to the CDC, cardiovascular diseases are the leading cause of death in the United States. Nearly one in 10 Americans has diabetes, and without intervention, this number will likely continue to grow. More than one-third of American adults have pre-diabetes, an estimated nine out of 10 of don't know they have it. The good news is many risk factors for these conditions can be prevented or managed with lifestyle changes between visits to the doctor. Success, in many cases, depends as much on lifestyle as it does on quality care.

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