CFO Playbook onHealth Care Cost Management
CFO Playbook on Health Care Cost ManagementGuests:• Wayne H. Miller, founder and CEO of Nura LifeSciences• Dr. Leonard A. ...
CFO Playbook on Health Care Cost Management• Self-funded corporate health care plans lack efficacydata.• As a result, the ...
CFO Playbook on Health Care Cost Management• Why is efficacy data missing?• The health care system was never built to coll...
CFO Playbook on Health Care Cost ManagementAnecdote from an official at a Fortune 100 companythat spends $100 million per ...
CFO Playbook on Health Care Cost Management• The backbone of the health care payment system iscoding.• Coding is based on ...
CFO Playbook on Health Care Cost Management• The embedded dysfunction of the health carepayment system influences the beha...
CFO Playbookon Health Care Cost Management• Until you access the data where it lives inthe process, you will be unable to ...
CFO Playbookon Health Care Cost Management• If real-time, health-treatment data iscaptured, that information would helpcor...
CFO Playbookon Health Care Cost Management• How does having this data reduce corporatehealth care costs?• Using an integra...
CFO Playbookon Health Care Cost ManagementCapturing the data is something only the privatesector can do.    Private secto...
CFO Playbookon Health Care Cost Management • Some self-funded plan data can be found:     Existing third-party administra...
CFO Playbookon Health Care Cost Management• Budgeting & forecasting health care costs havetraditionally relied on increasi...
CFO Playbookon Health Care Cost ManagementDr. Leonard WisneskiA presentation within today’s presentation thatwill:    Def...
Integrative Medicine:The Future of Healthcare Delivery   Leonard A. Wisneski, MD, FACP
A ROSE BY ANY OTHER          NAME• Integrative Medicine- Universities, Public• Complementary and Alternative Medicine  (CA...
National Center for Complementary &   Alternative Medicine (NCCAM)1. Formed in 1998 by Public Law 105-2772. Authorization ...
Definition of CAM              NCCAM Health promotion, illness prevention,and healing practices that are outsidewhat is co...
NCCAM“Integrative Medicine should integrate the  most effective treatments for patients by  combining both conventional an...
Consortium of Academic Health Centersfor Integrative Medicine (51 med schools)“The practice of medicine that reaffirms the...
NIH/NCCAM  CLASSIFICATION OF CAM1. Whole Medical         2. Mind-Body   Systems                  Medicine  •   Traditional...
NIH/NCCAM      CLASSIFICATION OF CAM3. Biologic-Based       5. Energy Therapies   Therapies              •   Therapeutic T...
Integrative Medicine:             Proposed Classification1.   Conventional Diagnostics and Therapeutics2.   Traditional Me...
THE EMERGINGPHILOSOPHY OF MEDICINE•   Remember the Healing Power of Nature•   View the Whole Person•   Identify and Treat ...
“Students must have sufficient knowledge of thecommonly employed alternative remedies tocounsel patients about those that ...
RECENT HISTORICAL MILESTONESPresident Clinton establishes the White HouseCommission on Complementary and AlternativeMedici...
SPECIALTY CENTERS FOR CAM      RESEARCH AND PRACTICESeveral academic centers including: • University of                   ...
SITE SELECTION AND METHODS• 60+ sites identified from Bravewell Clinical Network,  Consortium of Academic Health Centers f...
WHO WE ARE• AFFILIATIONS •   27 centers affiliated with a specific hospital •   26 centers affiliated with a healthcare sy...
THE NUMBERS GAME• 29 Centers • Questioned about treatment of• 20 Medical Conditions • Using• 34 Interventions• YIELDS A LO...
CONCLUSIONS AND NEXT STEPS• Integrative Medicine is an established part of  healthcare in the US with increasing acceptanc...
The Integrative Healthcare Policy          Consortium             (IHPC)
IHPC• Broad coalition of healthcare organizations,  clinicians, patients and educators• IHPC advocates for public policy t...
IHPC MissionTo direct the national healthcare agenda towards a health-oriented, integrative system, ensuring  all people a...
IHPC Accomplishments• National Policy Dialogue 2001  (Georgetown University)• National Educational Dialogue 2004  (Georget...
Affordable Care Act• Section 2706: Non-discrimination in healthcare• Section 3502: Inclusion of CAM practitioners in the  ...
CFO Playbookon Health Care Cost ManagementNext steps:• Collect data;• Create a business model that funnels the righthealth...
CFO Playbookon Health Care Cost Management Special invitations to CFOs • Create a list of 10 clinical conditions/areas on ...
CFO Playbookon Health Care Cost Management Special invitations to CFOs • If you already understand the benefits of an EVA ...
CFO Playbookon Health Care Cost ManagementSpecial invitations to CFOs and their colleagues:• Join the discussion about usi...
Cfo Magazine Nura Life Sciences Webinar Presentation On Integrative Medicine For Self Insured Payors
Cfo Magazine Nura Life Sciences Webinar Presentation On Integrative Medicine For Self Insured Payors
Cfo Magazine Nura Life Sciences Webinar Presentation On Integrative Medicine For Self Insured Payors
Cfo Magazine Nura Life Sciences Webinar Presentation On Integrative Medicine For Self Insured Payors
Cfo Magazine Nura Life Sciences Webinar Presentation On Integrative Medicine For Self Insured Payors
Cfo Magazine Nura Life Sciences Webinar Presentation On Integrative Medicine For Self Insured Payors
Cfo Magazine Nura Life Sciences Webinar Presentation On Integrative Medicine For Self Insured Payors
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Cfo Magazine Nura Life Sciences Webinar Presentation On Integrative Medicine For Self Insured Payors

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Cfo Magazine Nura Life Sciences Webinar Presentation On Integrative Medicine For Self Insured Payors

  1. 1. CFO Playbook onHealth Care Cost Management
  2. 2. CFO Playbook on Health Care Cost ManagementGuests:• Wayne H. Miller, founder and CEO of Nura LifeSciences• Dr. Leonard A. Wisneski, MD, FACP, clinical professorof medicine at George Washington University MedicalCenter, adjunct faculty in the division of integrativephysiology at Georgetown University 2
  3. 3. CFO Playbook on Health Care Cost Management• Self-funded corporate health care plans lack efficacydata.• As a result, the 50-year-old health care paymentsystem has become dysfunctional.• What is needed is an EVA approach to health carecost management which focuses on value. 3
  4. 4. CFO Playbook on Health Care Cost Management• Why is efficacy data missing?• The health care system was never built to collect thedata.• U.S. HHS official: “We don’t have a way to pay forthings that work.” 4
  5. 5. CFO Playbook on Health Care Cost ManagementAnecdote from an official at a Fortune 100 companythat spends $100 million per month on health care:  “We don’t have any data.”  No quantitative basis of how we will allocate the $1.2 billion health care budget.  This is how the self-insurer health care ecosystem works. 5
  6. 6. CFO Playbook on Health Care Cost Management• The backbone of the health care payment system iscoding.• Coding is based on how much training adoctor/practitioner has gone through, plus how muchtime a treatment takes.• But no data is collected related to telling companieswhether what they are paying for what works. 6
  7. 7. CFO Playbook on Health Care Cost Management• The embedded dysfunction of the health carepayment system influences the behavior ofconstituents.• As a result, it is nearly impossible to create incentivesto help create a more efficient system.• In addition, the current payment system does notcapture the activities of more than one millionpractitioners that work in the integrated medicine field. 7
  8. 8. CFO Playbookon Health Care Cost Management• Until you access the data where it lives inthe process, you will be unable to buildefficiency into the system.• Currently, the system pays for the time ofthe activity, not the value.• As a result, incentives are misaligned. 8
  9. 9. CFO Playbookon Health Care Cost Management• If real-time, health-treatment data iscaptured, that information would helpcorporations drill down into which treatmentswork and which ones don’t.• Integrated medicine is a multidisciplinaryapproach to health care, similar to the way amoney manager uses a portfolio approach todiversify risk. 9
  10. 10. CFO Playbookon Health Care Cost Management• How does having this data reduce corporatehealth care costs?• Using an integrated approach that includesconventional and alternative medicaltreatments drives value into your capitalspending. 10
  11. 11. CFO Playbookon Health Care Cost ManagementCapturing the data is something only the privatesector can do.  Private sector capital is at risk.  Corporations know how to use data to drive efficiencies.  This is similar to a supply chain exercise, which corporations regularly control. 11
  12. 12. CFO Playbookon Health Care Cost Management • Some self-funded plan data can be found:  Existing third-party administrators;  Mining claims data. • However, there are system snags:  Treatment innovation that is more expensive is more acceptable;  Treatment innovation that is less expensive cannot be measured or value quantified. 12
  13. 13. CFO Playbookon Health Care Cost Management• Budgeting & forecasting health care costs havetraditionally relied on increasing last year’sspending.• Yet the forecasting goal should be to reducelast year’s expenditures related to chronicconditions by 20% (chronic conditions accountfor 75% of all corporate expenditures).• Compensation incentives should drive thiscost-reduction effort. 13
  14. 14. CFO Playbookon Health Care Cost ManagementDr. Leonard WisneskiA presentation within today’s presentation thatwill:  Define integrated medicine for corporate executives;  Highlight research results from the Bravewell Collaborative;  Identify chronic pain as being paramount to lost employee time. 14
  15. 15. Integrative Medicine:The Future of Healthcare Delivery Leonard A. Wisneski, MD, FACP
  16. 16. A ROSE BY ANY OTHER NAME• Integrative Medicine- Universities, Public• Complementary and Alternative Medicine (CAM) - Government
  17. 17. National Center for Complementary & Alternative Medicine (NCCAM)1. Formed in 1998 by Public Law 105-2772. Authorization a) Conduct scientific research on CAM b) Train researchers c) Disseminate authoritative information about CAM to the public and health professionals d) 15 R 25 grants were awarded between 2000-2003 in order to support the incorporation of CAM information into allopathic health professions schools curricula at the undergraduate, graduate, and continuing education levels
  18. 18. Definition of CAM NCCAM Health promotion, illness prevention,and healing practices that are outsidewhat is considered to be conventionalmedicine.
  19. 19. NCCAM“Integrative Medicine should integrate the most effective treatments for patients by combining both conventional and alternative approaches to address all aspects of health and wellness – biological, psychological, social, and spiritual.”
  20. 20. Consortium of Academic Health Centersfor Integrative Medicine (51 med schools)“The practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals, and disciplines to achieve optimal health and healing.”
  21. 21. NIH/NCCAM CLASSIFICATION OF CAM1. Whole Medical 2. Mind-Body Systems Medicine • Traditional • Biofeedback Chinese Medicine • Hypnosis • Ayurveda • Meditation • Homeopathic • Prayer Medicine • Others • Others
  22. 22. NIH/NCCAM CLASSIFICATION OF CAM3. Biologic-Based 5. Energy Therapies Therapies • Therapeutic Touch • Dietary Therapy • Qi Gong • Herbal Medicine • Bioelectric Field • Neutraceuticals Manipulation4. Manipulative/Body • Reiki Based Methods • Diagnostic Devices • Osteopathic • Therapeutic Devices Manipulation • Chiropractic Medicine • Massage Therapy
  23. 23. Integrative Medicine: Proposed Classification1. Conventional Diagnostics and Therapeutics2. Traditional Medical Systems3. Bioenergetic Medicine4. Nutritional Based Therapeutics5. Manipulative/Body-Based Therapies
  24. 24. THE EMERGINGPHILOSOPHY OF MEDICINE• Remember the Healing Power of Nature• View the Whole Person• Identify and Treat the Cause• The Physician Is a Teacher• Prevention Is the Best Cure
  25. 25. “Students must have sufficient knowledge of thecommonly employed alternative remedies tocounsel patients about those that are harmful,those that might interact adversely withprescribed medications, those that are harmlessand can be used with impunity, and those thathave been shown to be beneficial.” Jordan J. Cohen, President of AAMC Academic Medicine, June 2000
  26. 26. RECENT HISTORICAL MILESTONESPresident Clinton establishes the White HouseCommission on Complementary and AlternativeMedicine Policy (2000).Founding of the Consortium of Academic HealthCenters for Integrative Medicine (2000).Formation of the Integrated Healthcare Policy Consortium (2001)Institute of Medicine CAM Conference (2003)Institute of Medicine CAM Conference (2009)Integrative Medicine in America Report (2012)
  27. 27. SPECIALTY CENTERS FOR CAM RESEARCH AND PRACTICESeveral academic centers including: • University of • University of Colorado Pennsylvania • Harvard University • Emory University • Johns Hopkins University • Georgetown • University of University Maryland • Oregon Health • UCLA Sciences University • University of Arizona • Scripps • Others
  28. 28. SITE SELECTION AND METHODS• 60+ sites identified from Bravewell Clinical Network, Consortium of Academic Health Centers for Integrative Medicine and suggested by IM leaders• 29 chosen to represent the field • Directed by MD, other doctoral level provider or nurse • In operation at least three years • Significant patient volume • Prior clinical contributions to the field • Sites only delivering non-conventional care not included• Directors responded to REDCap-based questionnaire• Site visits made by study team for qualitative data
  29. 29. WHO WE ARE• AFFILIATIONS • 27 centers affiliated with a specific hospital • 26 centers affiliated with a healthcare system • 25 centers affiliated with a medical school • 1 center affiliated with a nursing college• CARE MODELS • 26 offer consultative care • 18 offer comprehensive care • 13 offer primary care • 15 offer inpatient services at affiliated hospital• RESEARCH AND EDUCATION • 25 centers involved in research and 25 in provider education
  30. 30. THE NUMBERS GAME• 29 Centers • Questioned about treatment of• 20 Medical Conditions • Using• 34 Interventions• YIELDS A LOT OF NUMBERS!!!
  31. 31. CONCLUSIONS AND NEXT STEPS• Integrative Medicine is an established part of healthcare in the US with increasing acceptance and demand• Integrative Medicine is truly integrative• Integrative Medicine is being practiced in diverse sites with high concordance for specific conditions suggesting practice is evidence-informed• Prospective outcomes data and cost-effectiveness data should be collected• Systems to further identify and share best practices among centers and practitioners should be developed
  32. 32. The Integrative Healthcare Policy Consortium (IHPC)
  33. 33. IHPC• Broad coalition of healthcare organizations, clinicians, patients and educators• IHPC advocates for public policy that ensures all Americans access to safe, high quality, integrative, whole person healthcare• Integrative healthcare includes conventional, complementary and alternative disciplines in a collaborative effort to influence the future of healthcare delivery in the United States
  34. 34. IHPC MissionTo direct the national healthcare agenda towards a health-oriented, integrative system, ensuring all people access to the full range of safe and regulated conventional, complementary, and alternative healthcare professionals, therapies, and products, and to the building blocks ofhealth, including clean air, water, and a healthy food supply.
  35. 35. IHPC Accomplishments• National Policy Dialogue 2001 (Georgetown University)• National Educational Dialogue 2004 (Georgetown University)• National Stakeholders Conference 2010 (Georgetown University)• Responsible for several inclusions in ACA• Congressional Briefings 2011-2012
  36. 36. Affordable Care Act• Section 2706: Non-discrimination in healthcare• Section 3502: Inclusion of CAM practitioners in the Medical Home• Section 4001: National Prevention, Health Promotion, and Public Health Council• Section 4206: Demonstration projects concerning individualized wellness plans• Section 5001: National Healthcare Workforce Commission• Section 6301: Patient-Centered Outcomes Research• Section 2301: Coverage for freestanding birth center services
  37. 37. CFO Playbookon Health Care Cost ManagementNext steps:• Collect data;• Create a business model that funnels the righthealth care data into your working capital;• Reduce total cost of self-insured health careplans. 44
  38. 38. CFO Playbookon Health Care Cost Management Special invitations to CFOs • Create a list of 10 clinical conditions/areas on which your company spends the most amount of money. • Send the list to Wayne Miller who will produce a cost comparison between your current expense and the potential savings derived from a self-funded plan that includes conventional and integrated medicine.  Email: healthcare@cfo.com  Email subject line: Health Care Cost Comparison 45
  39. 39. CFO Playbookon Health Care Cost Management Special invitations to CFOs • If you already understand the benefits of an EVA approach to health care plans, and would like to find out more about participating in a demonstration project to lower your plan costs contact Wayne Miller.  Email: healthcare@cfo.com  Email subject line: Interested in Demonstration Project 46
  40. 40. CFO Playbookon Health Care Cost ManagementSpecial invitations to CFOs and their colleagues:• Join the discussion about using an EVA approachto reduce self-funded health care costs  Discussion Group on LinkedIn: http://linkd.in/QGhmy4  All participants in today’s webcast are pre- approved to join the LinkedIn discussion group.Stay tuned to our next CFO Playbook Webcast onThurs., Oct. 10, starting at 2 pm Eastern time –The CFO Playbook on Risk Management: BestPractices from the London Olympics 47
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