Clinical and cost outcomes of an integrative medicine IPA.
OBJECTIVE
We hypothesized that primary care physicians (PCPs) specializing in a nonpharmaceutical/nonsurgical approach as their primary modality and utilizing a variety of complementary/alternative medicine (CAM) techniques integrated with allopathic medicine would have superior clinical and cost outcomes compared with PCPs utilizing conventional medicine alone.


METHODS
Incurred claims and stratified randomized patient surveys were analyzed for clinical outcomes, cost offsets, and member satisfaction compared with normative values. Comparative blinded data, using nonrandomized matched comparison groups, was analyzed for age/sex demographics and disease profiles to examine sample bias.


METHODS
An integrative medicine independent provider association (IPA) contracted with a National Committee for Quality Assurance (NCQA)-accredited health maintenance organization (HMO) in metropolitan Chicago.


METHODS
All members enrolled with the integrative medicine IPA from January 1, 1999 through December 31, 2002.


RESULTS
Analysis of clinical and cost outcomes on 21,743 member months over a 4-year period demonstrated decreases of 43.0% in hospital admissions per 1000, 58.4% hospital days per 1000, 43.2% outpatient surgeries and procedures per 1000, and 51.8% pharmaceutical cost reductions when compared with normative conventional medicine IPA performance for the same HMO product in the same geography over the same time frame.


CONCLUSIONS
In the limited population studied, PCPs utilizing an integrative medical approach emphasizing a variety of CAM therapies had substantially improved clinical outcomes and cost offsets compared with PCPs utilizing conventional medicine alone. While certainly promising, these initial results may not be consistent on a larger and more diverse population.
Sarnat
Richard L
RL
Alternative Medicine Integration Group, LP, Highland Park, Ill 60035, USA. rsarnat@amibestmed.com
Winterstein
James
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data; D002641:Chicago; D002648:Child; D000529:Complementary Therapies / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D003365:Costs and Cost Analysis; D003625:Data Collection; D016527:Drug Costs; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007193:Independent Practice Associations / Q000191:economics / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D016037:Single-Blind Method; D016896:Treatment Outcome