Corporate Health Improvement Program
(CHIP)
Corporate Health Improvement Program
Program
(CHIP)
University
of Arizona Program in Integrative Medicine
At present, there is an unprecedented upheaval in American business seeking
creative solutions to the unchecked rise in medical benefit costs. Although
some managed care strategies have slowed the trend, they are not adequate
and may often be worse than the problem. A complete resolution requires effective
programs in several areas including comprehensive prevention, disease management,
and integrative medicine interventions evaluated for both clinical and cost
outcome.
This approach requires objective, longitudinal evaluations of both clinical
and cost outcomes to determine what does and does not work as a database
for formulating corporate and public policy. There is a broader economic
dimension to such an approach as well since excessive medical costs have
added a disproportionate share to the cost of every product and service during
the last decade. Since approximately half of the United State» annual
medical budget of $1.5 Trillion (15.3% of 2003 GDP) is in the hands of private
corporations, there is a major movement underway to determine the relative
portion to be expended on true health care, rather than exclusively on disease
treatment.
Integrative Medicine provides solutions for this problem
Integrative Medicine (IM) is healing-oriented medicine that takes account of
the whole person (body, mind and spirit), including all aspects of lifestyle.
It emphasizes the doctor-patient relationship and makes use of all appropriate
therapies, both conventional and alternative. In the case of heart disease,
for example, a conventional medical approach would focus on diagnosis and treatment
to include medications, medical management of risk factors and surgery if all
else fails. There are ongoing morbidity and mortality risks associated with
conventional therapy as well as increasing costs in both health care utilization
and lost productivity. The Integrative Medicine approach focuses on lifestyle
interventions such as diet, exercise,, mind-body modalities which are lower
in cost and have firm evidence-based support. This type of comprehensive approach
is associated with reduced morbidity and mortality and is more cost-effective.
Corporate Health Improvement Program
Beginning in 1984, the Corporate Health Improvement Program was founded
by Dr. Kenneth R. Pelletier at the University of California School of Medicine
in San Francisco with a grant from the Bank of America Foundation. The
purpose of Corporate Health Improvement Program was to develop and evaluate
innovative preventive health and medical interventions for both clinical
and cost effectiveness. The Corporate Health Improvement Program was transferred
in 1990 to Stanford University School of Medicine where it was known as
the Stanford Corporate Health Program.
Due to the growing interest in and success of Integrative Medicine,
in 2004, the Corporate Health Improvement Program program has moved
to the Program in Integrative Medicine at the University of Arizona.
The Program in Integrative Medicine (PIM) at the University of Arizona
PIM was founded by Dr. Andrew Weil at the University of Arizona in
1994 with the assistance of a core group of visionary leaders. Generous philanthropists
gave PIM its start. PIM's mission is to foster the transformation of
healthcare through innovative educational programs, outstanding research
and exceptional clinical care that integrates biomedicine, the complexity
of human beings, and the healing power of nature.
PIM is the only institution in the world that has taken on the challenge
of developing a comprehensive educational program in Integrative Medicine.
There are currently three fellowship training programs for physicians:
a Residential Fellowship, an NIH-sponsored Research Fellowship and a distributed
learning Associate Fellowship. PIM provides educational experiences
for medical students and residents as well as undergraduate and graduate
courses in Integrative Medicine. One of the newer programs involves a one-year
Fellowship for the Department of Defense and collaboration with six Family
Medicine Residence programs that will create a national model of a combined
family medicine residency and Integrative Medicine Fellowship.
Member Companies
Among the member companies participating in the Corporate Health
Improvement Program are: Corning, Ford, IBM, Kimberly Clark, Knight
Ridder, NASA, National Grid, Nestle, Partnership for Prevention. The CHIP
membership also includes Scottsdale Healthcare major health plans like Prudential
Insurance and American Specialty Health. Many have been members throughout
the entire 18 years of the Corporate Health Improvement Program.
Initial research projects ranged from the first mobile mammography screening
project at Levi-Strauss to a five year evaluation of an innovative PPO at
Southwestern Bell Corporation in conjunction with Johnson & Johnson.
Since the Corporate Health Improvement Program began in 1984, it has been
deliberately maintained as a small, select and evolving program in order
to address specific requests by the Corporate Health Improvement Program
member companies to conduct research projects in areas of interest to their
employees.
At the twice yearly meetings, the medical and/or personnel directors of
member corporations decide upon mutually interesting research projects
to be implemented and evaluated within their companies. Each project
is developed over a period of three to five years:
| Year 1: |
Identification of areas of mutual interest in the coalition of
university and corporate representatives through a series of needs
assessments and structured planning meetings |
| Year 2-3: |
Develop, implement, and evaluate mutually agreed upon programs
in prevention and disease management using an integrative medicine
approach with the criteria that these be workable in any business
or organization nationwide, and that self-care and employee leadership
be emphasized. Focus is upon both clinical and cost effectiveness
analysis. |
| Year 4-5: |
Conduct full-scale, longitudinal studies. Emphasis will continue
to be on the development and evaluation of practical programs in
health promotion for business and industry. |
Among the areas of research and development in the program are:
-
Applications of meditation and relaxation for stress management
-
Physical fitness and back saver programs
-
Integrative approaches to anxiety and depression in the workplace
-
Lifestyle management of women's health issues
-
Disease management of hypertension and coronary heart disease
-
Computer and/or telephone health delivery systems
-
Early cancer screening, especially mammography for women;
-
Smoking cessation and policy development '
-
Health promotion programs to reach minorities, dependents, and
retirees
-
Alcohol and substance abuse programs
-
Reaching small and/or remote worksites
Conclusion
Corporate Health Improvement Program expects to have a major, practical impact
on the redesign of medical benefits and employee health programs of the corporate
members. Based on the objective findings of both clinical and cost effectiveness,
the medical and human resource directors will be able to document the positive
impact of health plan innovations.
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