Aligning Incentives: The Project for Integrative Health and theTriple Aim
Tuesday, November 3, 2015
: 2:30 p.m. - 3:15 p.m.
Access to complementary, alternative, traditional and integrative services has been hampered since the beginning of the "integration" era 20 years ago by a problematic misalignment of incentives with regular medicine. In the production-based system, insurers function as cost-plus operators and delivery systems are most successful financially when they run up the maximum number of tests and procedures. This is an inhospitable environment for typically lower-cost, high-touch and frequently time-intensive integrative approaches and practitioners. Sections of the Affordable Care Act seek to advance the transition of this production-focused industry toward a values based system. This movement has been most widely captured as the Triple Aim: enhance patient experience, better population health and lower per capita costs. A principal mechanism is to shift financial and other incentives under which hospitals and primary care practices operate. In November 2011, the CEO of Allina Healthcare, the U.S. system that has the most significant integrative health initiative of any major system, observed that with theA.C.A.s changes under which systems “can get paid to keep people healthy,” he believes integrative medicine will shift from being a cost-center to an ally in meeting these goals. (1) With philanthropic backing, a 501c3 North American consortium of educators in the integrative health and traditional world medicine space has developed an open-access, web-based center to educate, convene and advocate on the potential for more successful integration, and thus access, in the emerging period of potentially aligned incentives. The presentation will include: background on the opportunity, discussion of the strategy selected (on a limited budget), the interprofessional and multi-stakeholder Advisory Team created, resources openly available, and outcomes of a survey that tested the postulate suggested by the Allina executive that doors would be opening. Participants in the session will learn about the survey outcomes, the opportunities in Accountable Care Organizations, resources developed by the project, emerging practices in Primary Care Medical/Health Homes, new partnerships, next steps, and ways they might choose to become involved.
(`1)Weeks J. Health System & Military Leaders Say Cost and Pain are Motivating Inclusion of Integrative Medicine
Advocacy for health and health education
Chronic disease management and prevention
Provision of health care to the public
Public health or related public policy
Explain how the challenges to integrative health from the "perverse incentives" in production-focused payment and delivery have limited integration and how the emergence of the values of the Triple Aim are creating a new alignment and opportunities.
Discuss an interprofessional project aimed to support all stakeholders in creating the optimal use of the values, practices and disciplines associated with integrative health and medicine in advancing Triple Aim values.
Identify the areas where leaders of health system-based integrative centers are finding increased openness to their services in the post A.C.A. environment.
Keyword(s): Alternative and Complementary Health, Affordable Care Act
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: As E.D. for ACCAHC I helped found the Center for Optimal Integration: Creating Health and helped conceive the development of the Project for Integrative Health and the Triple Aim as the director of the Center. I was lead on the survey of leaders of integrative centers in large health systems that will be reported. I have reported on and spoken extensively on the business models and challenges in integrative care. See www.theintegratorblog.com
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.