The Center for Optimal Integration: Creating Health has announced results of a survey found that integrative health and medicine is increasingly viewed by involved health systems as integral to advancing the values of the "Triple Aim."
The term "integrative health and medicine” typically applies to such therapies as mind-body and yoga and practitioners like acupuncturists, massage therapists, chiropractors and naturopathic doctors.
The area of most significant engagement of integrative medicine leaders by their parent systems was found to be in initiatives to enhance patient experience. Nearly 9 in 10 (87%) agreed that, under the new incentives of the Affordable Care Act, their parent systems are increasingly interested in how integrative health and medicine can help meet patient experience targets.
The survey, through the Center's Project for Integrative Health and the Triple Aim (PIHTA), found other positive alignments. These leaders of health system-based integrative centers perceive they are increasingly valued as part of their system’s efforts to "reduce hospital re-admissions" (72%) and "lower costs"(75%). Many report new outreach from system specialty groups to explore partnerships. A subset are finding increased financial investment.
When the exploration of complementary and integrative medicine originated in the mid-1990s, the relationship with conventional delivery systems was quickly hampered by misalignment. The prevailing "perverse incentives” from a payment and delivery focus on procedures proved an inhospitable environment for these typically high-touch, time-intensive and human-centric integrative services.
I served on the PIHTA team that developed the survey. The questions we asked essentially tested an assertion of Allina Health’s CEO Ken Paulus as the A.C.A. was coming into being in 2011. Allina’s integrative health and medicine program, is the most significant in the United States. At that time, the in-patient and outpatient integrative initiative at Allina had been nurtured for a dozen years via substantial philanthropic investment from the George Family Foundation started by Penny George and her spouse, Bill George. The latter is the former Medtronic chair and present author-professor at Harvard Business School.
Paulus told a New York City audience of integrative medicine leaders that when he took the job at Allina in 2006, he judged integrative medicine to be "a cost center.” But as now the A.C.A. "is paying us to keep people healthy,” Paulus sees integrative medicine as an ally. He believes that as the A.C.A.’s payment structure "kicks in that supports keeping people healthy, integrative medicine will be an asset."
The data in this survey suggest that Paulus’ assertion is correct. Surveyed were leaders of 28 integrative medicine clinics most of which are part of academic health centers. The set of participants was the same as those in the widely reported Integrative Medicine in America (2012) project engaged by the Bravewell Collaborative of philanthropists in integrative medicine. Seventy-five percent (21/28) took part in the PIHTA survey.
Many of these health system-based integrative medicine centers were originally developed for marketing purposes. The core interest was to gain competitive advantage by showing responsiveness to patient interest in complementary and alternative therapies and practitioners.
These data make abundantly clear that interest is deepening from these early adopters. Integrative approaches and practitioners are edging into core business models of hospitals and other delivery organizations. Data charts on the all survey outcomes are available here.
The PIHTA survey team also included Jeffrey Dusek, PhD, the research director at the Penny George Institute (PGI) to Allina, Melinda Ring, MD who directs the Osher Center for Integrative Medicine at Northwestern and Jennifer Olejownik, PhD, PIHTA’s manager.
Some outcomes on integrative care that are shaping system interest are contained in the PGI reports at this link. In addition, the PIHTA initiative that engaged the survey has posted what we hope are useful links to resources on lowering costs and others on enhancing patient experience.
Both existing data from pioneers and the timing in health system maturation suggest that integrative practices will continuously be woven more tightly into strategies to provide accountable, values-based care.
John Weeks is the director of the Center for Optimal Integration: Creating Health where he is actively involved in the Center’s Project for Integrative Health and the Triple Aim (PIHTA). He is a 30-year veteran as writer, organizer, speaker and executive in the integrative care movement.