• The National Committee for Quality Assurance could expand efforts to monitor preventive practices of managed care plans through its Health Plan Employer Data and Information Set system.

  • Employers and other group benefit managers could define performance targets for health education and preventive counseling to hold health plans accountable for the provision of these services (Schauffler et al., 1999; Schauffler and Rodriguez, 1996).

  • The Joint Commission on the Accreditation of Healthcare Organizations could evaluate the availability of services to promote risk behavior change as part of its accreditation process.

The aging of the nation’s population will sharply increase the demand for certain cancer prevention services such as colorectal screening and mammography, and impending shortages of trained personnel have been predicted. If such shortages are anticipated, policies to address them will need to be identified.

  • The Health Resources and Services Administration should assess the adequacy of the future supply of providers of cancer prevention and early detection services.

There is convincing evidence that nonphysician providers are just as effective as physician providers in delivering certain smoking cessation and screening services, but research is needed on how to integrate provision of prevention services by such providers into routine primary care.

  • The Agency for Healthcare Research and Quality and other research sponsors should support demonstration programs to evaluate innovative models of prevention service delivery.

Recommendation 9: The U.S. Congress should provide sufficient support to the U.S. Department of Health and Human Services for the U.S. Preventive Services Task Force and the U.S. Task Force on Community Preventive Services to conduct timely assessments of the benefits, harms, and costs associated with screening tests and other preventive interventions. Summaries of recommendations should be made widely available to the public, health care providers, and state and local public health officials and policy makers.

Evidence-based guidelines for clinical and community practice provide maps for action. Two task forces provide rigorous assessments of the effectiveness of preventive services.

The U.S. Preventive Services Task Force, overseen by the Agency for Healthcare Research and Quality, has provided comprehensive assessments of clinical prevention services. Until recently, it has been convened only



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