Evidence-based practices benefit entire communities at a low cost.
While healthcare organizations have offered integrative health services such as massage therapy, acupuncture, and neurofeedback for the last two decades, most patients do not benefit from them due to sporadic offerings and high out-of-pocket costs. Ruthann Russo, PhD, and her employer Berkeley Research Group (BRG) aim to change this through a unique integrative population health (IPH) program. “Research shows that as many as 67% of hospitals offer integrative services to their patients that are managed as a revenue center and generally not covered by insurance. We want to do better,” says Russo.
IPH programs provide integrative healthcare services that help patients manage chronic conditions efficiently and at a low cost. Integrative health involves using natural and/or traditional interventions along with conventional medicine treatments, notes Russo, managing director at BRG in New York City. “IPH is a data-driven, evidence-based, customized, and person-focused methodology that helps healthcare organizations, hospitals, and employers expand their influence in the communities they serve, and it can be used in conjunction with a population health program,” says Russo, who develops programs for healthcare organizations and Fortune 500 companies.
How IPH works
IPH includes evidence-based therapies provided by a licensed and/or certified practitioner. It also uses integrative practices, which are first taught by a practitioner and later practiced independently by patients. Such practices include meditation, yoga, guided imagery, self-hypnosis, biofeedback, and acupressure.
Integrative therapies and practices can be used to treat the symptoms of almost any chronic condition, including diabetes, tobacco abuse, hypertension, obesity, and anxiety and depression, says Russo. She notes that while both integrative therapies and integrative practices are essential in helping patients manage chronic conditions, the latter are more effective in IPH, as they can be taught in a group setting to larger numbers of patients at a lower cost. For example, meditation is particularly effective in helping people with diabetes maintain stable blood sugar levels.
“We focus primarily on helping hospitals implement programs centered around teaching integrative practices to groups of patients,” says Russo. “Research shows that when you train people in a group setting, they not only learn the modality, but also are able to practice it, and this changes the patient’s behavior.”
Critical juncture: Why it’s the right time for IPH
Using IPH to help manage chronic conditions is cost-effective and creates a “significant and interesting competitive advantage,” says Russo. “These interventions provide a relationship-building opportunity with patients who are looking for help to improve their health, well-being, and lifestyle.” Research also tells a compelling story on the benefits of integrative health interventions, she adds. BRG research shows that in the state of Maryland, which operates the Maryland All-Payer Model, 83% of inpatients ages 5 and older can benefit from integrative health interventions.
IPH and traditional chronic disease management programs have key differences. Most traditional programs use case managers who provide one-on-one interventions with patients. IPH, however, focuses on group and community interventions and emphasizes health coaching. “To improve sustainability, we use evidence-based health coaching, as opposed to instruction,” says Russo. This involves guiding people through the stages of change and engaging them in specific communication techniques that help them learn from their peers.
Getting started
“Follow the data” to determine if IPH is right for your organization, recommends Russo. Data analytics clearly show the benefits of IPH from clinical, financial, and patient experience perspectives. “In our program, we analyze the research on every integrative practice and the clinical evidence supporting its efficacy in managing the symptoms of certain chronic conditions,” says Russo. The program matches ICD-10 codes to a specific hospital’s claim database to determine the percentage of patients who could benefit by participating in an IPH program. “Also, we can provide data analysis before and after an intervention and show its impact on medication use, length of stay, and overall patient satisfaction,” says Russo.
The medical literature builds a compelling case for using integrative practices, she adds. For example, one study shows that Beth Israel Deaconess Medical Center in Boston saved an estimated $367.50 per patient by providing hypnosis to reduce patients’ anxiety during interventional radiology procedures, producing estimated savings of $1.6 to $2.4 million annually.
It’s important to start with a strong team, says Russo: “Our teams employ doctoral-level-prepared professionals.” For organizations that are interested but not ready to fully commit, she suggests attempting an employee pilot program. “We have had a lot of interest from self-insured hospitals that want to try out the program with staff and even physicians and senior leaders. This gives you an opportunity to see if it is right for your organization and to build support, which is so critical with new programs.”