Seven years ago, David Fogel, MD set the goal of proving what he hoped could be a primary care cornerstone of a transformed system of health care. With a generous philanthropic grant, he and his spouse Ilana Bar-Levav, MD created a team-based integrative health patient-centered medical home (PCMH). To give it power as a national model, the integrative PCMH was fully webbed into the emergent accountable care and value-based system. Early cost and health outcomes at their CHI Health Care significantly outperformed conventional practice metrics. They drew a visit from a US Surgeon General who was in search of innovative, value-based models. Yet now comes news that on July 23, 2019, the Center will shut its doors. An apparent guiding light for health system transformation will be snuffed. What gives?
Spoiler alert. The title of a recent column marking the 10th anniversary of Triple Aim efforts to move medical payment and delivery from volume toward value makes no bones about the effort’s shortcomings. This report card from the Triple Aim’s top cheer-leader is meaningful to the high touch, human-intensive movement for integrative health and medicine for one important reason: the field’s potential uptake is pegged to advance of the values orientation. Success is more broadly meaningful because the values-based war against the forces in the industry that causally associate it with 250,000 medical deaths each year – effectively medicine’s white walkers in Game of Thrones terms – is the bullseye point of reference on what is at stake.