by John Weeks, Publisher/Editor of The Integrator Blog News & Reports

Cleveland Clinic Announces Partnership with the Institute for Functional Medicine

“If we can show that we have better outcomes and it’s cheaper to take a functional approach, in the end, the doctors who adopt this model—and their patients—they will be the ones who win.” This is Institute for Functional Medicine (IFM) president Mark Hyman, MD, in an article in the widely read political blog The Daily Beast in June 2014 in which he mentioned that he was working with the Cleveland Clinic to create a program in functional medicine. On September 15, 2014, an article in Crain’s Cleveland Business propelled news of the program nationally. The highly-regarded Cleveland Clinic is not merely dabbling in the field but entering a full partnership with IFM, according to the release from the Cleveland Clinic. IFM’s chief medical officer Patrick Hanaway, MD will be on the ground in Cleveland with author Hyman also serving in leadership.

The Crain’s article notes a strong research focus in the partnership: “Plans for the center include four clinical trials focusing on the treatment of asthma, i

by John Weeks, Publisher/Editor of The Integrator Blog News & Reports

Cleveland Clinic Announces Partnership with the Institute for Functional Medicine

“If we can show that we have better outcomes and it’s cheaper to take a functional approach, in the end, the doctors who adopt this model—and their patients—they will be the ones who win.” This is Institute for Functional Medicine (IFM) president Mark Hyman, MD, in an article in the widely read political blog The Daily Beast in June 2014 in which he mentioned that he was working with the Cleveland Clinic to create a program in functional medicine. On September 15, 2014, an article in Crain’s Cleveland Business propelled news of the program nationally. The highly-regarded Cleveland Clinic is not merely dabbling in the field but entering a full partnership with IFM, according to the release from the Cleveland Clinic. IFM’s chief medical officer Patrick Hanaway, MD will be on the ground in Cleveland with author Hyman also serving in leadership.

The Crain’s article notes a strong research focus in the partnership: “Plans for the center include four clinical trials focusing on the treatment of asthma, inflammatory bowel disease, type 2 diabetes and migraines.” Cleveland Clinic CEO Toby Cosgrove, MD said the new center is “not a departure for Cleveland Clinic, but a continuation of the innovative, holistic approach that we have embraced.” The initiative is examined in this Huffington Post piece.

Comments: Integrator editorial Adviser Sabin and I share extensive comments on his FON Therapeutics site where I first posted on this topic, at Sabin’s invitation, with many captured in this Huffington Post piece noted above that I subsequently filed. They circle around the pricey office fees, tests and supplements of many functional medicine practices, and question the fit in the Cleveland Clinic environment. What will this clinical and business model look like? The Huffington Post piece includes an excellent comment from the Institute of Functional Medicine that speaks to this question.

 

Richard Sarnat and the AMI Group: Update on a Trailblazing Data Producer for the Integrative Health and Medicine Field

When the Samueli Institute pieced together the cost document to support its Wellness Initiative for the Nation (WIN), it cited the AMI Group’s incredible outcomes from an integrative primary care network contracted with BCBS’s HMO Illinois. Integrative chronic pain pioneers seeking model projects for the underserved may remember the outcomes from AMI’s historic program with Florida Medicaid. In a recent interview for this article, co-founder Richard Sarnat, MD, an ophthalmologist turned integrative primary care physician with a 40 year meditation and Tai Chi practice, shared that the AMI “continues to enjoy small victories” in its work to prove that cost savings can come with patient-centered care via well-structured integrative practices.

Sarnat offered a quick update on the firm’s business. AMI’s Illinois integrative primary care network was just one of very few independent practitioner associations selected for expansion into the continued business options offered by Illinois Blue Cross Shield’s HMO post implementation of the Affordable Care Act. HMO Illinois enrollment has seen a “15% to 20% uptick in volume” post ACA. Almost 3 years ago, legislation in Rhode Island led to selection of AMI to deliver an integrative chronic pain program for the Medicaid population there. In Rhode Island, the firm is working closely with United Health Care, that firm’s behavior health providers, as well as Neighborhood Health Plans (NHP).

Like the former Florida program, the Rhode Island initiative is built around holistic nurses with mind-body skills, tools and a model that allows them more time with each client. They collaborate with local primary care networks, plus massage therapists, acupuncturists, chiropractors and nutritionists. AMI also has added newer business in Idaho, and continues with a core contract for managed chiropractic services, forged with the Maryland Chiropractic Association, that reaches into Washington, D.C. and Virginia. Adds Sarnat: “We’re increasingly a technology company, building our own data informatics platforms in order to generate the variety of outcomes reports that clients are now interested in.” Speaking to the importance of generating outcomes: “We were into the idea of big data before anyone called it “big data.” Disclosure: AMI was an Integrator sponsor from 2008-2011.

Comment: Sarnat was upbeat about outcomes in each of the programs. I asked him if AMI had any new data to share. He said that independent third party analysis suggests that in the Rhode Island program, total service utilization by the population they serve through their intensive program appears to be down by over by 20%. Yet because AMI doesn’t own the data, hard numbers will not be officially made available for at least a few months.  Meantime, especially for those who have known Sarnat from the Integrative Medicine Industry Leadership Summit days when he was reporting initial outcomes of AMI’s Illinois pilot, the most important new data-point on Sarnat is that he’s had a central role in creating and growing Fairfest, a Bonnaroo-type music festival in his home town of Fairfield, Iowa (fairfestiowa.com). The annual June free event drew some 16,000 people in its second year to see Los Lobos and others – and also drew sponsorship from the town’s Chamber of Commerce!  Old rockers never die…

 

Cheng-Tsui Integrated Care Center: “Imbedded” in ACO and Emergent PCMH at Harvard

The model is “embedded,” according to Aditi Nerurkar, MD, MPH, assistant medical director with the Chen-Tsui Integrated Care Center at Beth Israel Deaconess Medical Center of the Harvard Medical School. In an e-correspondence, Nerurkar noted that among the “differentiators” for the Center are that it is: within a primary care setting within an academic medical center; all providers are “vetted by the primary care practice administration;” and all Chen-Tsui practitioners “write notes within the electronic medical record (EMR), and loop back to the referring physician.” The service includes: acupuncture, massage, nutrition services – the most frequently offered – and also yoga, Tai chi, Mindfulness-Based Stress Reduction, and exercise. According to data shared by Nerurkar, 73% of patients are female with the average age of the served population 56.  She notes that the primary care practice, Health Care Associates, is “moving towards a PCMH model.” In addition, it is part of the Harvard Pioneer Accountable Care Organization and engaged in the major initiative to redesign primary care through the Center for Primary Care at Harvard. Kim Ariyabuddhiphongs, MD serves as Chen-Tsui’s medical director.

Comment: The service is as yet young, with only 85 patients, for instance, seen for acupuncture since the beginning of 2013. Yet at the same time, with the EMR, the potential for data collection and dissemination is significant. Here’s hoping this Center becomes a learning opportunity for all of us.