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"Wellness" Advances: Policy, Employers, MPA Media, Accreditation Standards, IOM Summit, plus PDF Print E-mail
Written by John Weeks   

"Wellness" Advances: Policy, Employers, MPA Media's Program, Accreditation Standards, IOM Summit, plus

Summary:  US Senate health policy leader Tom Harkin (D-IA) is talking of recreating the U.S. as a "wellness society" ... Reports from Towers Perrin and Aon show employer interests in wellness programs are up, despite the economic downturn ... Large complementary and alternative healthcare media firm, MPA Media, announces plans to create Integrated Wellness Pavilions at major trade shows ... URAC, the national accrediting body, promulgates standards for Comprehensive Wellness Accreditation ... The IOM-Bravewell Summit explores wellness themes ... Are we seeing a paradigm shift toward health and wellness? Will integrative practice professions be seen as leaders in this shift, which most view as their birthright?
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The American Association of Naturopathic Physicians and other leading national associations involved with integrative practice are looking prescient at this moment. Their push of an initiative to require that quality wellness programs be included in health reform package would appear to be right on the track of a core message in the emerging healthcare reform dialogue, and practice. (See Historic Alliance: Integrative Practice Groups United Behind Conmgressional Resolution Promoting Wellness.") As noted in this Integrator article, health reform leader US Senator Tom Harkin is presently talking of recreating the U.S. as a "wellness society." Key elements seem to be falling in place.

But will the integrative practice disciplines help shape the wellness agenda or merely draft in behind it? Here are some trend-lines and related action.

Employer consultant finds use of HRAs will jump
1.    Interest in wellness programs from employers up, despite economic downturn

The Kaiser Health Policy Report referenced a trio of studies which offer insight into employer thinking regarding wellness. First, a Towers Perrin study of Fortune 500 firms concludes that "interest in wellness programs has doubled in the last 5 years." Meantime, an Aon consulting report suggests that the number of employers offering a health risk assessment (HRA) to their employees, typically an anchor component for a wellness program, will jump from 48% to 66% from 2008 to 2009.

Employees, however, still don't seem to be on the bandwagon. A StayWell Health Management leader shares that a $100 cash inducement to an employee to participate in an HRA induced 75% to participate in 2002. By four years later, $100 bought just 50% participation.
Comment: There does seem to be a deep disconnect between employers and employees on these health and wellness campaigns. One wonders if the programs might go over better if the wellness initiatives were engaged, where unions exist, as employer-union partnerships. 
2.   URAC announces Comprehensive Wellness Accreditation standards

URAC (the accrediting agency which now uses only its acronym) announced in a November 19, 2008 release that is has approved standards and measures for its Comprehensive Wellness Accreditation program. The standards, according to the release, "are meant to reinforce and support the commitment that employers and wellness organizations have to ensuring the heath and productivity of America's workforce." URAC's "program specific" standards are in 5 categories. They were described as follows:

  • Assessment: Includes risk identification and risk awareness program components, such as the use of Health Risk Assessments;
  • Interventions: Addresses overall program design, health coaching, and use of consumer participation incentives, education and communications aspects of wellness programs;
  • Evaluation: Focuses on how the wellness organization calculates, measures, and reports participant progress and overall clinical and financial program success to the client;
  • Integration: Focuses on an organization's ability and willingness to coordinate with other organizations, operations, and programs already in place; and
  • Measurement: Focuses on producing and reporting to purchasers and the public on a specified set of performance measures.

Douglas Metz, DC, executive vice president an chief health services officer with San Diego-based American Specialty Health, served as chairman of the URAC Wellness Accreditation Advisory Committee which developed the standards.
Metz is quoted this way: "Over the growth cycle of many years, wellness programs have evolved and matured to become a critical component of employer and health plan benefits. High quality and effective wellness programs hold tremendous potential to reduce health risks, lower health care costs, and increase productivity. URAC's Comprehensive Wellness Accreditation standards define an industry-accepted baseline for quality standards. Organizations that pursue accreditation can demonstrate that their processes and quality systems meet or exceed these industry standards. These standards will support the industry as organizations adopt and implement quality management systems and processes." (For those new to the field, American Specialty Health is the largest managed CAM firm in the nation.)
Comment: URAC's action is timely. There is great opportunity here for the integrative practice community. The challenge is to explore the fit between "wellness" as seen and implemented in integrative practice and the URAC standards. My guess is that few administrators of integrative centers, or educators or researchers in the complementary health care and integrative practice communities are aware of the standards. If wellness in integrative practice-speak and wellness in employer-speak are not thoughtfully aligned, the use of integrative services in wellness will remain under-utilized.
CAM media firm promotes CAM as integrated wellness
3.   MP Media sponsors CAM-focused "Integrative Wellness Pavilions" at key trade shows

MPA Media recently used its various online publications and a release to announce that it will
be the "exclusive media sponsor" of the Integrated Wellness Pavilion at the Spa & Resort Expo/Medical Aesthetics Conference & Expo at the Los Angeles Convention Center Feb. 21-22, 2009. The firm publishes Naturopathy Digest, Dynamic Chiropractic, Acupuncture Today, Massage Today and Nutritional Wellness.

Donald Peterson, Jr., MPA Media's publisher and president explains the initiative by saying that "e
veryone knows patients want their health care providers to work together for their benefit." He adds that "patients want their health care providers to focus on wellness." Peterson believes these patient interests are here to stay: "These trends are irreversible."

MPA Media decided to invest in bringing the disciplines together via the
Integrated Wellness Pavilion. The firm plans to congregate information about four distinct health professions (DC, AOM, ND, massage therapy) in a single area of the show floor together with materials from related vendors. The firm anticipates rolling out the Pavilion for a similar conference in New York in late 2009.
Comment:  Here is hoping that MPA Media will approach this with imagination, presenting the disciplines not merely for their roles in disease management, the corner into which biomedical research tends to paint them, but for their potential in creating health and wellness.
Will NCCAM ever explore wellness approaches?
4.  NCCAM and wellness?

Comment:  As noted above, "wellness" is a concept that tends to flow easily from the lips of practitioners across the integrative practice communities. Most have their origins in principles which are implicitly or explicitly wellness-focused. To date, however, the billion-plus dollars spent by NCCAM in the Stephen Straus years was prioritized based on the NIH's reductive, disease oriented approach and hardly touched on the potential value in wellness. Wellness be damned.

Imagine what a public service
NCCAM would have performed
had it begun its work in 1999
by openly exploring the claims
that quality integrative practice
is wellness-focused care.

A recent Integrative Practitioner interview with Josephine Briggs, MD, Straus's successor, suggests some potential for a shift in investment. Briggs indicates that NCCAM will show a greater focus on effectiveness and "real world" research. One hopes that by "real world" we mean the actual one, in which wellness is in great need of prioritization.

Briggs also shows some responsiveness to employer interests. These new dierctions - depending on the actual allocation of funds - could be very useful. The future allocations are late, however, for the current health reform moment. Imagine what a public service NCCAM would have perfiormed it it had the courage to begin its work in 1999 by openly informing and exploring the claims for these disciplines that they represent new wellness models?

Summit may help re-position integrative practices
5.   Will the Bravewell-IOM Summit explore integrative practice as a wellness model?

Will "wellness" play an important role in the February 25-27, 2009 National Summit on Integrative Medicine and the Health of the Public as sponsored by the Institute of Medicine and the Bravewell Collaborative. We can see some potentially hopeful signs here.

The IOM-Bravewell Summit
may prove very helpful in
positioning "integrative medicine"
as a wellness-oriented
model of care.

The first focus group, as noted on the Draft Agenda site, will explore the "components of integrated health." A segment on models of care asks what are the models of "interdisciplinary patient-oriented care." Among themes in the science section are approaches that look at "wellness and nutrition." Workforce issues turn to competencies in such areas as "healthy living, wellness and nutrition." The fifth focal theme of the Summit, economics, includes specific notice of employer interests such as presenteeism that are wellness-related. The session promises to explore "potential returns from integrative medicine in providing savings from healthy living."

Given the disavowal by Bravewell leaders on the Charlie Rose Show that the Summit is about "CAM," one may wonder whether these hopeful themes will be associated with integrative practices of distinctly licensed practitioners. On the face of it, however, the Summit may prove very helpful in positioning "integrative medicine" as a wellness-oriented model of care.

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