Artz Kristi E, Phillips Timothy D, Moore Janine M, Tibbe Kara E
Lifestyle Medicine, Corewell Health West, Grand Rapids, MI.
Population Health, Corewell Health West, Grand Rapids, MI.
Mayo Clin Proc Innov Qual Outcomes. 2024 Aug 12;8(5):418-430. doi: 10.1016/j.mayocpiqo.2024.07.001. eCollection 2024 Oct.
Value-based health care has been accelerated by alternative payment models and has catalyzed the redesign of care delivery across the nation. Lifestyle medicine (LM) is one of the fastest growing medical specialties and has emerged as a high-value solution for root cause treatment of chronic disease. This review detailed a large integrated health care delivery system's value transformation efforts in the nonoperative treatment of musculoskeletal (MSK) conditions by placing patient-centric, team-based, lifestyle-focused care at the foundation. With an economic and treatment imperative to reimagine care, recognizing more intervention is not always better, a collaborative approach was designed, which placed functional improvement of the patient at the center. This article described the process of implementing LM into an MSK model of care. The change management process impacted clinical, operational, and benefit plan design to facilitate an integrated care model. A new understanding of patients' co-occurring physical impairments, medical comorbidities, and behavioral health needs was necessary for clinicians to make the shift from a pathoanatomic, transactional model of care to a biopsychosocial, longitudinal model of care. The authors explored the novel intersection of the implementation of a biopsychosocial model of care using LM principles to achieve greater value for the MSK patient population.
基于价值的医疗保健因替代支付模式而加速发展,并推动了全国医疗服务提供方式的重新设计。生活方式医学(LM)是发展最快的医学专科之一,已成为慢性病根本原因治疗的高价值解决方案。本综述详细介绍了一个大型综合医疗服务提供系统在以患者为中心、基于团队、注重生活方式的护理基础上,对肌肉骨骼(MSK)疾病非手术治疗的价值转变努力。鉴于重新构想护理的经济和治疗紧迫性,认识到更多干预并不总是更好,设计了一种协作方法,将患者的功能改善置于中心位置。本文描述了将生活方式医学纳入肌肉骨骼疾病护理模式的过程。变革管理过程影响了临床、运营和福利计划设计,以促进综合护理模式。临床医生需要对患者同时存在的身体损伤、合并症和行为健康需求有新的认识,以便从病理解剖学、交易性护理模式转向生物心理社会、纵向护理模式。作者探讨了运用生活方式医学原则实施生物心理社会护理模式的新交叉点,以为肌肉骨骼疾病患者群体实现更大价值。