Alliances with Lifestyle Medicine for Wellness as a Service

Ingrid Edshteyn, DO, MPHAssociate Executive Director

American College of Lifestyle Medicine

Lifestyle

Lifestyle

What is Lifestyle Medicine?

The use of lifestyle interventions in the treatment and prevention of disease

• Providing guidelines & guidance• Prescribing lifestyle change as

treatment• Coaching patients through change

Lifestyle Medicine WorksNutrition Counseling

Physical Activity

Spahn JM. J Am Diet Assoc. 2010;110(6):879–891. Delahanty LM. J Am Diet Assoc. 2001;101(9):1012–1023. Pastors JG. Diabetes Care. 2002;25(3):608–613.Sheils JF. J Am Diet Assoc. 1999;99(4):428–435. Contento IR. J Nutr Educ. 1995;27:277–418.Dalziel K. Health Promot Int. 2007;22(4):271–283Merrill RM. Prev Chronic Disease. 2008 5:1;1-13.

Lifestyle Medicine WorksIntensive Therapeutic Lifestyle Change

Works

PritikinOrnish

Complete Health Improvement Program

Hall, John A., And James R. Barnard. Journal Of Cardiac Rehabilitation 2.7 (1982): 569-574.Ornish, D. M., Et Al. Clinical Research. Vol. 27. No. 4. Ornish, Dean, et al The Lancet 336.8708 (1990): 129-133.Diehl, Hans A. The American journal of cardiology 82.10 (1998): 83-87.

In a nutshell…

Prescribe lifestyle change as first line therapy and supplement with

medication as needed for all patients with lifestyle diseases

Successful outcomes contingent upon active participation of patients

Lifestyle in Medicine

Only 3% of our health care spending is focused on prevention and public health,

…while 75% of our health care costs are related to preventable conditions.

National Health Expenditure Data. Baltimore, MD: U.S. Centers for Medicare and Medicaid Services, December 2014. For the Public’s Health: Investing in a Healthier Future. Washington, D.C.: Institute of Medicine, April 2012.

Optum White Paper: Getting them in to win 2015

“To provide for expanded and sustained national investment in

prevention and public health programs to improve health and

help restrain the rate of growth in private and public health care costs.”

• ACA authorized $18.75 billion for the fund between FY 2010 - FY 2022 • $2 billion per year afterwards

• $2.9 billion investment … estimated to save $16.5 billion annually within five years (in 2004 dollars)

• Supports a variety of community prevention and clinical prevention programs

http://healthyamericans.org/health-issues/wp-content/uploads/2015/02/150219_PPHF.pdf

Diabetes Prevention

Heart Disease and Stroke Prevention

Smoking & Health

January 1, 2018

First time a preventive service model from the CMS Innovation Center

expanded into the Medicare program

Health Care 2017?

This is consumer-

driven wellness

The Lifestyle Medicine Movement

• Physicians in a Health System

The Lifestyle Medicine Movement

• Lifestyle Medicine Practices

Synergy

Precision Population Wellness

Miles to go before we sleep..• Only 3% had healthy levels of all 4

lifestyle behaviors

Non-smokingHealthy weight

5 fruits and vegetables per day Regular physical activity

Reeves & Rafferty, Arch Intern Med, 2005

Miles to go before we sleep..• Only 3% had healthy levels of all 4

lifestyle behaviors

Non-smokingHealthy weight

5 fruits and vegetables per day Regular physical activity

Reeves & Rafferty, Arch Intern Med, 2005

• Only 2.7% of all adults had all 4 healthy lifestyle characteristics.

Non-smokingHealthy body fat %

Healthy DietRegular physical activity

Loprinzi, Paul D., et al. Mayo Clinic Proceedings. Vol. 91. No. 4. Elsevier, 2016.

• Only 2.7% of all adults had all 4 healthy lifestyle characteristics.

Non-smokingHealthy body fat %

Healthy DietRegular physical activity

Loprinzi, Paul D., et al. Mayo Clinic Proceedings. Vol. 91. No. 4. Elsevier, 2016.

Ingrid Edshteyn, DO, MPHAssociate Executive Director