On the surface of things, the values of “accountable care” and “patient-centered medical homes (PCMH)” and those of integrative medicine suggest a convergence. A survey found alignment in integrative medicine leaders. Maryland integrative doctors David Fogel, MD, and his spouse Ilana Bar-Levav, MD, presented with a substantial philanthropic gift, jumped into the apparently convergent rivers with both feet, creating the interprofessionally rich environment that is now CHI Health Care. The goal was and remains to prove the value proposition of integrative medicine in the medical industry’s move from volume to value. The center gained recognition as a PCMH and became part of a Medicare Shared Savings accountable care organization (ACO). Now Fogel makes clear that the convergence of the two paradigms have produced rumblings of boulders at the river bottom. While he remains positive about the model, the systemic obstacles are daunting.
An alert went out two weeks ago to a set of policy-oriented integrative health and medicine types. The Trump administration had published a report – “Reforming America’s Healthcare System Through Choice and Competition.” The email suggested that there was support here for the non-discrimination in healthcare provision of the Affordable Healthcare Act (a.k.a. “Obamacare”). Was this actually a dovetailing support of the Trump administration with the healthcare policy of his predecessor? I took a look and then connected a lobbyist who was on the ground when the Obama administration’s Section 2706: Non-Discrimination in Health Care was being drafted. The findings on the Trump study were mixed.
In 2015, the legislature in the state of Wyoming made a significant investment in the idea that its people and communities could benefit if the National Acupuncture Detoxification Association (NADA) 5-point ear acupuncture protocol was put in the hands of the people. They created a law that allowed any adult U.S. citizen with an interest, who took and completed the appropriate NADA training, to provide the services. And unlike other states that might limit services to a few conditions or locations, this piece of Wild West legislation allowed the practice for stress relief, for pain, for loneliness, grief and whatever else may be tearing at one’s vital force, at fire stations or churches, community centers or malls, and whereever else “ADSes” – as they call themselves – might gather one of more interested recipients. The experiment is most under way in Laramie, Wyoming, population 30,000. Can the Laramie experience be a healing tool for the nation?
From 30,000 feet – where I sit – it’s easy to proclaim all the reasons why group visits are a terrific fit for the values and practice of integrative health and medicine. Docere. What better format than groups? Adults learn better interactively. Groups are mediums for taking power in oneself and changing lifestyle. Now a presentation through the Academic Consortium for Integrative Medicine and Health (“the Consortium”) offers data on how group visits both expanded access and increased revenues in integrative health services. Meantime, peer-reviewed journal JACM has announced that it is developing an entire Special Focused Issue on Innovation in Group-Delivered Services.