The AMI Advantage
THE SOLUTION TO ESCALATING HEALTH CARE COSTS: An American Experience
Health Care or Wealth Care Is is all about money?
16 September, 2002 Linda Eldridge Alternative Medicine Integration Group, LLC (AMI)
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The AMI Advantage
“The current (health) care systems cannot do the job. Trying harder will not work. Changing systems of (health) care will…” (p. 4) “IOM has documented three types of quality problems – overuse, under-use and misuse… We need a new vehicle or perhaps, many new vehicles. The only unacceptable alternative is not to change.” (p. 24)
Source: Institute of Medicine (IOM), Crossing the Quality Chasm
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The AMI Advantage
The majority of health care resources are now devoted to the treatment of chronic diseases…$425 billion direct costs and $234 billion in indirect costs – lost productivity due to premature death or inability to work in the year 1990.” (p. 27, IOM) About 1 in 6 Americans is limited in daily activities…as a result of a chronic condition (The Robert Wood Johnson Foundation, 1996)
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The AMI Advantage Commitment to Wellness
• Provide the missing foundation of wellness and prevention to our “disease care” system (conventional medicine) • Promote quality physicians who utilize non-pharmaceutical/ non-surgical treatments as their primary modality • Develop an integrated medical model which combines the best of complementary/alternative medicine with the best of conventional medicine • Scientifically document the clinical outcomes and cost savings of this integrated model.
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The AMI Advantage
The AMI Model
• Integrates complementary alternative and allopathic medicine appropriately through MD and DC oversight • Supports optimal health throughout health cycle • Focus on quality via credentialing & outcomes • Educates patients and physicians • Encourages use of equally effective alternative options as most conservative course of treatment • Documents downstream savings
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The AMI Advantage
Complementary Alternative Medicine
• • • • • • Chiropractic Care Massage Therapy Acupuncture Stress Management Nutrition Herbal Medicine • • • • Homeopathy Cranial Sacral Therapy Ayurvedic Medicine Traditional Chinese Medicine
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The AMI Advantage
The AMI Delivery Model
“Best Medicine of Both Worlds”sm
1. Portal of Entry: Primary care trained DCs 2. Allopathic Support Systems 3. Integrative Medical Management
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The AMI Advantage
The AMI Delivery Model
“Best Medicine of Both Worlds”sm 1. Portal of Entry: Primary care trained DCs
– – – – – – Shared Scientific Base of Knowledge Prevention & Optimal Health Training Non-pharmaceutical & Non-Surgical Patient Education Multiple CAM Modality Certifications Credentialed to Same Standards as PCP MDs
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The AMI Advantage Quality through AMI Credentialing - URAC
• CAM physicians with extensive experience in providing multiple CAM modalities. • Meets NCQA and URAQ criteria equivalent to conventional medical physicians • Appropriateness of Conventional Medical Referrals • Superior Communication Skills • Shared Base of Scientific Knowledge • Exclusive National Credentialing Agent for the American Academy of Chiropractic Physicians (AACP) • Chiropractic Colleges & Universities…
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The AMI Advantage
The AMI Delivery Model
“Best Medicine of Both Worlds”sm 2. Allopathic Support System
– Hospital and Outpatient Facilities – MD Specialists – Specialized Medical Directors
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The AMI Advantage
“The Best Medicine of Both Worlds”sm 3. Integrative Medical Management • MD Medical Director Integrates Care
– – – – – Co-management Prescriptions Referrals Hospitalizations Recovery
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The AMI Delivery Model
• Outcome-Based Decisions
The AMI Advantage
HMO EXPERIENCE Alternative Medicine, Inc.
January 1, 1999 – December 31, 2001 Hospital Admissions/1000 Reduced by Hospital Days/1000 Reduced by OP Surgical Cases/1000 Reduced by Average Length of Stay Reduced by Pharmaceutical Usage Reduced by
*OB excluded from comparative data
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56.8% 73.2% 67.8% 32.0% 51.8%
The AMI Advantage
Comparison of “well” patients AMI vs. Control
IPA Members enrolled Members with none or non ICD-9 encounters 149 2618 3206 Percentage of members coded as “wellness” 28.5% 34.7% 42.0% AMI Control group #1 Control group #2 523 7549 7723
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The AMI Advantage
Comparison Of Diagnostic Demographics By Percentage Of Member Enrollment AMI vs. Control
Diagnosis Wellness Orthopedic Other medical Mental health Gyne (non OB) Sinus/chronic allergy Cardiac/hypertension Headache (all variants) Neoplastic (all) URI Asthma GI Diabetes Thyroid disease (all) AMI % 28.5% 23.5% 11.7% 8.1% 6.7% 6.0% 4.6% 2.7% 1.5% 1.5% 1.4% 1.3% 1.2% 1.2% Control Group #1 34.7% 8.0% 17.0% 1.3% 9.4% 2.8% 9.4% 0.7% 1.1% 10.4% 1.3% 0.9% 3.4% 1.4% Control Group #2 42.0%
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The AMI Advantage
Smoker Prevalence Rate AMI vs. Controls
AMI Population Smoker Prevalence Rate
* National data source: MMWR 2000; 50: 1101-1106
HMO General Population 18.0%
Illinois General Population* 22.3%
34.9%
AMI responses based on 84/295 answered surveys for a 28.5% response rate
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The AMI Advantage
AMI Patient & Client Satisfaction
• Patient Satisfaction Survey
– Exam Thoroughness
– – – – – Accuracy of Diagnosis Medical Care Access re: Appointments Access Re: Emergencies, Wait Time Care and Courteousness
• Client Satisfaction Audit
– Medical = 100%
– Administrative = 99%
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The AMI Advantage
Carves-Into Existing (Business) Relationships
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The AMI Advantage
Why is AMI the Solution?
Traditional CAM Programs…
Isolate CAM Benefits Limited Access/Utilization Not Diagnosis or Severity Driven Minimal Credentialing Standards Not Primary Care Oriented No Integration of Care or Data No Documentation of Savings
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The AMI Advantage
AMI Timeline
June 1997 October 1998 January 1999 April 2000 May 2000 November 2000 January 2001 February 2001 April 2001 AMI Founded AMI Primary Care Chiropractic Panel Approved/Credentialed by BCBS IL HMOI Effective Date Year 1 Cost Offsets Documented AACP Endorsement/Selection First Executive Optimal Health Client First Group Health PPO Client First Workers Compensation Client Formal Recognition of AMI Model by ACA Board of Governors
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The AMI Advantage
“The doctor of the future will interest his patients in the use of diet, exercise, in the frame of the body and in the cause and prevention of disease.”
~Thomas Edison
1847-1931
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