FON Therapeutics' Glenn Sabin Promotes "Marriage" Between Integrative Medicine and Self-Insured Employers

Summary: On his FON Therapeutics site, integrative center consultant, blogger and Integrator adviser Glenn Sabin recently posted a piece on perhaps the most hopeful yet unrealized partnership that integrative health and wellness interests can forge: with self insured employers. Sabin approaches it as a match-maker, listing the value first to the employer and then to the integrative medicine community with which he consults. I add links to a half dozen articles that further explore the employer/integrative medicine relationship.

Glenn Sabin

Integrative healthcare providers have been well positioned to provide quality corporate wellness programs and executive physicals for some time. Closely connected to this phenomenon, literally, is the largely overlooked fact that more than 100 million Americans today receive their healthcare benefits through self-insured companies.This article describes how integrative medicine can help employees stay healthier and be more productive while reducing their employers' healthcare costs. Importantly, the increasing uptake of integrative health approaches by self-insured employers also offers unprecedented business opportunity for the practitioners and centers delivering integrative care.

WHY SELF-INSURED CORPORATIONS SHOULD CARE ABOUT INTEGRATIVE MEDICINE

Self-insured companies of varying sizes enter into agreements with traditional insurance companies to administer their plans. These corporations take the risk of covering their employees directly and often save a good deal of money as a result. Add wellness programs and executive physicals, and the savings become larger. Clearly, self-insured employers have been taking the initiative to keep their employees healthy.

Healthy employees save their employers money. A healthy workforce increases productivity, reduces absenteeism, and, critically, decreases "presenteeism" (a word so new that my word processor is telling me it is a typo. It's not!). You see, it's not enough in this hyper-competitive, 21st century global economy to get workers to simply show up - they need to be healthy, pain-free and happily engaged. Presenteeism is the increasing phenomena in the US workplace where workers are on the job physically, but suffering from chronic disease, pain or other physical or psychological issues. This greatly reduces employees' optimal level of productivity.

Wellness programs and executive physicals are keeping more employees healthy. Integrative health services can play a role in that process, as well as provide additional, substantive savings when used to improve the quality of life of employees dealing with chronic illness. Self-insured employers spend 75% of their healthcare dollars on chronic conditions. As recent research and increasing experience demonstrates, this is an area where integrative medicine excels.

MOMENTUM BUILDS FROM INTEGRATIVE EXPERIENCE

Large employers like Parker-Hannifan in Cleveland have been covering integrative medicine services for their employees for a number of years. Other large employers such as Dow and SAS have implemented and broadened the availability of integrative therapies such as tai chi, yoga and mindfulness-based stress reduction. These interventions and programs not only reinforce well-being but also provide relief in cases of recovery from procedures and coping with chronic illness.

The economic benefits of these processes have been slow to appear, but are now finding the light of well-compiled research. Patricia Herman, MS, ND, PhD, an economist and naturopathic doctor, recently led a comprehensive systematic review of economic evaluations of complementary and integrative medicine covering a period of nine years. Two dozen quality studies indicated the cost-effectiveness of delivering integrative healthcare. This research was well described in a piece in the Huffington Post by John Weeks, editor-publisher of The Integrator Blog.

Earlier this month, Len Wisneski, MD, FACP, chair of the Integrative Healthcare Policy Consortium (IHPC), presented a webcast for CFO Magazine to more than 250 corporate financial executives. An MD and integrative physician of long experience, he described the capability of integrative medicine as a practical way to rein in spiraling healthcare costs. (CFO webinar slides here; requires free registration: The CFO Playbook on Health Care Cost Management.)

One of the most enduring information and research programs to embody integrative health in corporate work-sites is the Corporate Health Improvement Program (CHIP), established at the University of Arizona's Center for Integrative Medicine in 2002. The program is funded by a number of large global self-insuring corporate members including Ford, IBM, Nestle, Pepsi, Pfizer and Prudential. Its current focus is on "integrative medicine's clinical and cost-effectiveness to corporate America."

These examples demonstrate how the overwhelming rise in health care costs is being confronted by the entities that pay a huge portion of the nation's $2.7 trillion annual health bill: business, which accounts for 37% of that total spend. These cases also demonstrate that integrative health practices have made and continue to make steady inroads into their planning and programs.

THE OPPORTUNITY FOR PROVIDERS OF INTEGRATIVE HEALTHCARE

While growing during this transitional period for all of US healthcare, the uptake of integrative health and wellness approaches by employers and healthcare providers has been spotty. Adoption depends largely on senior leadership's belief that integrative options benefit employees and patients, respectively. Some large city and county governments such as the city of Chicago and Maricopa County, Ariz.-each acutely sensitive to health cost issues-are also starting to put wellness programs in place.

In the case of some hospital systems that feature integrative services, their staffs may have easier access to these choices than their patients. This can be attributed to a number of factors including continuing exclusion of most integrative therapies from the remuneration system. But this is all starting to change. For instance, as with the use of acupuncture for pain management and an integrative regimen for cardiovascular treatments developed by Dr. Dean Ornish, the Multisite Cardiac Lifestyle Intervention Program now accepted by Medicare.

As the provisions of the Affordable Care Act go into effect in 2014, it is likely that structures meant to focus on reducing the cost of care, such as the Patient Centered Medical Home (PCMH), may embrace many integrative therapies in their clinical programs.

Traditional health management firms are developing and implementing corporate health and wellness programs. But most do not yet have an informed appreciation of the efficacy, safety and cost qualities of evidence-based integrative approaches. The same is still true for most employers. Local integrative practitioners will find opportunities by proactively seeking opportunities to inform and educate senior executives in human resources or corporate health programs in their areas, in particular those with self-insured companies.

As a practical matter, practitioners who believe their therapeutic and clinical services belong in wellness programs are now positioned to take the initiative. Those who can articulate the health and cost benefits are likely to find a receptive audience among self-insured businesses who are taking the initiative to control their health care costs by improving the health and productivity of their employees. Moreover, as the large self-insured firms start to include integrative approaches, their experience will ultimately influence companies of all sizes.

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• National Employer Group CMO on CAM/IM and Agreements for a New Employer-Practitioner Relationship
• Acupuncture for Ford Motor Company Employees: Challenges in Mounting an Pilot Project
• "Health Enabling" Corporations: Integrative Medicine and Health & Productivity Management
• Top 10 Reasons to Attend IHPM's Employer-Focused Conference, October 15-17, 2008
• IHPM/Employer Focus: Intel Explores Manual Therapies as an Onsite Musculoskeletal Pain Solution
• Notes on Integrative Care and Health and Productivity Management from the IHPM Conference
• IHPM Conference to Cross-Fertilize Employer-Integrative Health Care: March 31-April 2, Orlando