CFO Magazine would seem an unlikely source of cheerleading for more inclusion of complementary and integrative medicine practices and providers into U.S. health care delivery. Yet the magazine that targets chief financial officers (CFOs) of Fortune 500 firms has been shaking those pom poms in recent months.
There is a smart economic alignment that connects these stakeholders at the economic hip. They may even be a perfect marriage, as one writer recently put it.
An October CFO Playbook on Health Care Cost Management webinar featured the medical doctor who chairs the most significant lobbying group for integrative health care, the Integrative Healthcare Policy Consortium. The presentation from Leonard Wisneski, M.D., was assertively titled "Integrative Medicine: The Future of Health Care Delivery." Wisneski, a former medical officer for a large employer, urged extensive piloting of integrative approaches for their cost-saving possibilities.
Later that month, CFO featured an expansive alternative medicine benefit program offered by the $13 billion global manufacturer Parker Hannifin. The article led with a similarly assertive title -- though this time as a question: "A Solution to Our Country's Big Health Care Problem?" Parker Hannifin's CEO Don Washkewicz is confident the answer is yes: "[The program is in its] early days, but we're going to aggregate this and show the payoff in lower costs." His confidence beams through: "And then we're going to publicize the hell out of it."
Parker Hannafin's early data are these. The firm's expansive complementary and integrative medicine benefit includes 23 different types of a-typical treatments. These range from typical fare like therapeutic massage and acupuncture to chelation therapy (which recently merited a positive report from a huge National Institutes of Health trial), bio-identical hormone therapy and homeopathy. The 8-year-old CAM program has grown from 27,000 services performed in fiscal 2009 to 102,000 in 2012.
While the company has not tracked details on cost impacts, Parker Hannifin's corporate unit with the most use of such services has reportedly seen annual per-employee medical costs sink by more than half between 2007 and 2012, from $6,500 to $3,200. The firm does not know what portion, if any, may be attributable to the alternative medicine benefit. Washkewicz' comment suggests that the global manufacturer likes the trend.
While the second installment of the two CFO articles presented a more sober picture, CFO deputy editor David McCann followed with a Nov. 5, 2012 column that likely pushed the magazine's readers even farther out of their comfort zones. McCann's piece was entitled "To Cure Health Care, We Must Think Bigger, Much Bigger."
McCann urged bold explorations after a recent Robert Wood Johnson report that, in his words, "indicted the health care system for its failure to develop and deliver effective preventive strategies." Maybe, McCann suggests, "we should be open to different approaches instead of continuing to defend and turn blind eyes to the deficiencies of the old ones." He adds, "maybe giving [complementary and alternative medicine] a fair shot isn't so revolutionary after all."
According to McCann, data may soon be coming from other sources. He shares that former pension finance consultant Wayne Miller has "declared a crusade to assemble the health care informatics needed to assess CAM versus traditional approaches." Miller arranged the webinar on potential costs savings with Wisneski that kicked off CFO Magazine's flurry of activity in this area.
Momentum may indeed be picking up for a greater exploration by employers. As noted in a series of short reports here, players on both sides of the integrative medicine/employer divide are beginning to reach across to each other. Positive outcomes of a Cisco Systems LIfeConnections medical home that includes chiropractic and acupuncture, for instance, were reported out at a recent National Business Coalition on Health conference.
Rand Corporation economist and naturopathic physician Patricia Herman, ND, Ph.D., who recently saw published a systematic review of cost effectiveness studies on complementary and integrative medicine, has teamed up with the Samueli Institute to publish a how-to book on economic analysis in these fields.
Integrative medicine consultant and blogger Glenn Sabin needs no more evidence. In a recent posting he declared, "Self-Insured Employers and Employers: A Perfect Marriage."
Sabin's view is one I have held for nearly 15 years. (See eight related links on the employer connection at the bottom of this posting.) Early efforts to integrate complementary and alternative medicine therapies and practitioners with conventional delivery -- later called integrative medicine -- taught us a hard lesson. Hospitals weren't going to make money with "CAM" the way they do with high-priced services like interventional cardiology.
Rather, the big money in complementary and integrative medicine fields and their preventive and health promoting focus that CFO Magazine's McCann notes is not in churning services. It is in saving money by limiting services. Use of lucrative interventional cardiology services may be reduced. Hospital business models typically don't like this. Employer business models do.
The CFO Magazine series was published amidst growing bitterness among employers toward the extractive practices that have shaped the business of medicine in recent decades. The boom was leveled by Paul Grundy, M.D., MPH, IBM's health care leader at an August 2012 Institute of Medicine workshop. As reported here, Grundy addressed leaders of academic medical centers bluntly: "You are a milking machine." Then Grundy added: "You are going to see a remorseless campaign in the press about how bad you are." Later he added: "You are the lobster in water. Slowly we will change payment away from the [procedure and] episode of care ..."
The direction away from these old forms of payment as the battle between the titans of industry and the titans of medicine-as-business escalates is toward payment to practitioners and team of caregivers who can reverse disease processes. These are models in which individuals and groups are coached toward skill-building to make healthier choices. Such approaches are being innovated in fields like naturopathic medicine and integrative medicine and other whole-person, health-creating disciplines.
Employers would do well to think bigger, as CFO Magazine exhorts, and out of the box of conventional delivery. Engaging in data-extracting pilot projects like the radically-inclusive Parker Hannifin benefit may prove the perfect courtship for the kind of prevention-oriented health care marriage employers seek.
For more by John Weeks, click here.
For more on integrative medicine, click here.