This document summarizes a presentation on reducing corporate health care costs. It discusses how the current US healthcare payment system lacks efficacy data and incentives are misaligned, focusing on costs rather than value. It advocates capturing real-time treatment data to identify effective treatments. Integrating conventional and alternative approaches could drive value by reducing costs for chronic conditions, which account for 75% of expenditures. Next steps proposed include collecting health data, creating a business model to analyze the data and reduce costs of self-insured plans.

1. CFO Playbook on
Health Care Cost Management

2. CFO Playbook
on Health Care Cost Management
Guests:
• Wayne H. Miller, founder and CEO of Nura Life
Sciences
• Dr. Leonard A. Wisneski, MD, FACP, clinical professor
of medicine at George Washington University Medical
Center, adjunct faculty in the division of integrative
physiology at Georgetown University
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3. CFO Playbook
on Health Care Cost Management
• Self-funded corporate health care plans lack efficacy
data.
• As a result, the 50-year-old health care payment
system has become dysfunctional.
• What is needed is an EVA approach to health care
cost management which focuses on value.
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4. CFO Playbook
on Health Care Cost Management
• Why is efficacy data missing?
• The health care system was never built to collect the
data.
• U.S. HHS official: “We don’t have a way to pay for
things that work.”
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5. CFO Playbook
on Health Care Cost Management
Anecdote from an official at a Fortune 100 company
that 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.
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6. CFO Playbook
on Health Care Cost Management
• The backbone of the health care payment system is
coding.
• Coding is based on how much training a
doctor/practitioner has gone through, plus how much
time a treatment takes.
• But no data is collected related to telling companies
whether what they are paying for what works.
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7. CFO Playbook
on Health Care Cost Management
• The embedded dysfunction of the health care
payment system influences the behavior of
constituents.
• As a result, it is nearly impossible to create incentives
to help create a more efficient system.
• In addition, the current payment system does not
capture the activities of more than one million
practitioners that work in the integrated medicine field.
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8. CFO Playbook
on Health Care Cost Management
• Until you access the data where it lives in
the process, you will be unable to build
efficiency into the system.
• Currently, the system pays for the time of
the activity, not the value.
• As a result, incentives are misaligned.
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9. CFO Playbook
on Health Care Cost Management
• If real-time, health-treatment data is
captured, that information would help
corporations drill down into which treatments
work and which ones don’t.
• Integrated medicine is a multidisciplinary
approach to health care, similar to the way a
money manager uses a portfolio approach to
diversify risk.
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10. CFO Playbook
on Health Care Cost Management
• How does having this data reduce corporate
health care costs?
• Using an integrated approach that includes
conventional and alternative medical
treatments drives value into your capital
spending.
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11. CFO Playbook
on Health Care Cost Management
Capturing the data is something only the private
sector 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.
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12. CFO Playbook
on 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.
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13. CFO Playbook
on Health Care Cost Management
• Budgeting & forecasting health care costs have
traditionally relied on increasing last year’s
spending.
• Yet the forecasting goal should be to reduce
last year’s expenditures related to chronic
conditions by 20% (chronic conditions account
for 75% of all corporate expenditures).
• Compensation incentives should drive this
cost-reduction effort.
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14. CFO Playbook
on Health Care Cost Management
Dr. Leonard Wisneski
A presentation within today’s presentation that
will:
 Define integrated medicine for corporate
executives;
 Highlight research results from the
Bravewell Collaborative;
 Identify chronic pain as being paramount
to lost employee time.
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15. Integrative Medicine:
The Future of Healthcare Delivery
Leonard A. Wisneski, MD, FACP

16. A ROSE BY ANY OTHER
NAME
• Integrative Medicine- Universities, Public
• Complementary and Alternative Medicine
(CAM) - Government

17. National Center for Complementary &
Alternative Medicine (NCCAM)
1. Formed in 1998 by Public Law 105-277
2. 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. Definition of CAM
NCCAM
Health promotion, illness prevention,
and healing practices that are outside
what is considered to be conventional
medicine.

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. Consortium of Academic Health Centers
for 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. NIH/NCCAM
CLASSIFICATION OF CAM
1. Whole Medical 2. Mind-Body
Systems Medicine
• Traditional • Biofeedback
Chinese Medicine • Hypnosis
• Ayurveda • Meditation
• Homeopathic • Prayer
Medicine • Others
• Others

22. NIH/NCCAM
CLASSIFICATION OF CAM
3. Biologic-Based 5. Energy Therapies
Therapies • Therapeutic Touch
• Dietary Therapy • Qi Gong
• Herbal Medicine • Bioelectric Field
• Neutraceuticals Manipulation
4. Manipulative/Body • Reiki
Based Methods • Diagnostic Devices
• Osteopathic • Therapeutic Devices
Manipulation
• Chiropractic
Medicine
• Massage Therapy

23. Integrative Medicine:
Proposed Classification
1. Conventional Diagnostics and Therapeutics
2. Traditional Medical Systems
3. Bioenergetic Medicine
4. Nutritional Based Therapeutics
5. Manipulative/Body-Based Therapies

24. THE EMERGING
PHILOSOPHY 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. “Students must have sufficient knowledge of the
commonly employed alternative remedies to
counsel patients about those that are harmful,
those that might interact adversely with
prescribed medications, those that are harmless
and can be used with impunity, and those that
have been shown to be beneficial.”
Jordan J. Cohen, President of AAMC
Academic Medicine, June 2000

26. RECENT HISTORICAL MILESTONES
President Clinton establishes the White House
Commission on Complementary and Alternative
Medicine Policy (2000).
Founding of the Consortium of Academic Health
Centers 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. SPECIALTY CENTERS FOR CAM
RESEARCH AND PRACTICE
Several 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

29. 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

30. 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

33. THE NUMBERS GAME
• 29 Centers
• Questioned about treatment of
• 20 Medical Conditions
• Using
• 34 Interventions
• YIELDS A LOT OF NUMBERS!!!

37. 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

38. The Integrative Healthcare Policy
Consortium
(IHPC)

39. 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

40. IHPC Mission
To 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 of
health, including clean air, water, and a healthy
food supply.

41. 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

42. 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

44. CFO Playbook
on Health Care Cost Management
Next steps:
• Collect data;
• Create a business model that funnels the right
health care data into your working capital;
• Reduce total cost of self-insured health care
plans.
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45. CFO Playbook
on 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
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46. CFO Playbook
on 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
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47. CFO Playbook
on Health Care Cost Management
Special invitations to CFOs and their colleagues:
• Join the discussion about using an EVA approach
to 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 on
Thurs., Oct. 10, starting at 2 pm Eastern time –
The CFO Playbook on Risk Management: Best
Practices from the London Olympics
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