IHPC develops strategies for healthcare policy amid pandemic, social unrest

Over the past few months, the novel coronavirus (COVID-19) has shifted priorities around the country swiftly and profoundly. Through the lens of the Integrative Health Policy Consortium (IHPC), Capitol Hill has been no exception.

Prior to the pandemic, the IHPC was engaged in a campaign to build key relationships to advance the integrative health and wellness agenda. At the heart of this plan was building the Congressional Health and Wellness Caucus, which is currently co-chaired by Representatives Judy Chu (D-CA) and Jackie Walorski (R-IN).

At the time, our policy strategy could be characterized as a four-legged stool. Consider the seat of that stool to be the creation of a strong bipartisan congressional caucus supported by four strategic issues. These four legs need to engage leaders on both sides of the aisle with solutions that will benefit their constituents while having impact on major segments of the nation’s population. The stool is only as stable as any one leg.

In March, with onset of COVID-19, everything changed and the IHPC’s main methods for engaging members of Congress were banned. Face-to-face visits with staffers were cancelled, as was a congressional briefing we had planned to begin as the first of a series in May.

Along with the rest of the country, our integrative healthcare community faced the more immediate problem of financial survival in the wake of the pandemic. The IHPC Capitol Hill outreach team responded, focusing on stimulus and relief legislation to ensure integrative practitioners were not overlooked. The organization’s prior strategic agenda fell into the shadows of the pandemic.

In the past few weeks, the United States has again erupted in response to deep structural inequities and institutional racism which, along with COVID-19, will be central political themes for the foreseeable future. The IHPC is now faced with an important challenge in how it can reengage congressional leaders and reestablish momentum for core policy initiatives that will benefit integrative medicine.

Months after the IHPC’s policy work was upended, the four strategic legs remain the same, championing systemic, structural change to U.S. healthcare and prioritizing proactive health creation over reactive disease management.

1. Pain and Opioid Crisis

There is strong evidence that the opioid crisis has worsened since COVID-19. It affects all states and congressional districts and there is interest on both sides of the aisle for practical, achievable, and cost-effective solutions.

According to the Centers for Disease Control and Prevention, 50 million adults in the U.S. have chronic daily pain and the cost of pain to our nation is estimated at between $560 billion and $635 billion annually.  In response, the Pain Management Best Practices Inter-Agency Task Force was convened in 2019 by the U.S. Department of Health and Human Services in conjunction with the U.S. Department of Defense and the U.S. Department of Veterans Affairs with the Office of National Drug Control Policy to address acute and chronic pain in light of the ongoing opioid crisis. The 29-member task force mandate was “to identify gaps, inconsistencies, and updates and to make recommendations for best practices for managing acute and chronic pain.”

The final report emphasized an individualized, patient-centered, multidisciplinary approach using one or more treatment modalities. Five major categories were detailed including behavioral approaches and complementary and integrative health services such as acupuncture, massage, chiropractic and other manipulative therapies, movement therapies like yoga and tai chi, mindfulness, and spirituality. Although the HHS report came out a year ago, there is still little awareness about this landmark federal document.

IHPC Focus: An assertive campaign to educate, advocate, and take actions that lead to the implementation of the HHS Task Force Report recommendations, highlighting the use of its complementary and integrative health components.

2. Whole-Person Health Approach to Care

It is well-documented that the U.S. spends almost twice as much per capita on healthcare than any other developed country in the world, with significantly worse health outcomes, particularly in the management of chronic diseases like diabetes, hypertension, and heart disease. It is also increasingly understood that a whole-health, person-centered, integrative and wellness approach to healthcare is both cost-effective and successful at treating, and in some cases reversing, several chronic diseases.

The whole-person health model transcends any one health discipline or tradition and leverages a person-centered, interprofessional team-based approach. Like the HHS recommendations for effective pain management, whole-person health can have multiple simultaneous benefits impacting physical health, mental health, and an improvement in overall sense of wellbeing.

IHPC Focus: Launch a campaign to educate, advocate, and endorse actions that promote acceptance of a whole-person approach to care, highlighting the growing evidence of its impact on health and cost outcomes.  

3. Veteran’s Health

The military has been a leader for over a decade in piloting integrative approaches to healthcare. In 2016, the Veterans Health Administration (VHA) via the Office of Patient-Centered Care and Cultural Transformation formalized the Whole Health System of Care, an approach incorporating patient-centered care and complementary and integrative health.

In 2018, the VHA began implementing their three-year Whole Health System pilot program.  Preliminary results are promising and point to improved health and cost outcomes. A final report is due in July 2020 to both the House and the Senate. The VHA Whole Health System program is an unprecedented opportunity to showcase the successful application of a comprehensive, integrative, whole-person approach to health in a federal system that serves one of the largest populations in the country.

IHPC Focus: Promote the VHA Whole Health System program as an effective, federally sanctioned, and funded systems approach to healthcare.  

4. Federally Qualified Health Centers

Federally Qualified Health Centers (FQHC’s) are a nationwide network of federal, state, and privately-funded community health centers that serve more than 28 million people, providing essential health services to the uninsured and underinsured at little to no cost to the patient. These centers offer care for one in 12 people in the country, one in 9 of which are children, and 400,000 of which are veterans. There are approximately 12,000 Health Resources & Services Administration (HRSA) funded community health centers across the U.S.

FQHC’s have long addressed the economic and social drivers that are essential components of a comprehensive approach to population health. These issues are gaining bipartisan support under the umbrella of the Social Determinants of Health (SDOH). In 2019, Senator Todd Young (R-IN) introduced the Social Determinants Accelerator Act, a bill designed to facilitate state Centers for Medicare and Medicaid Services (CMS) funded grants for programs targeting high need Medicaid recipients using innovative Social Determinants Accelerator Plans.

The IHPC supports funding for FQHCs as fundamental to its mission to eliminate barriers to health.  Additionally, since FQHCs often benefit from more programing flexibility than other federally funded programs, they are a growing source of innovative and integrative models of care.  

IHPC Focus: Promote the funding for FQHCs and champion their efforts to create health equity and health creation for a large and growing cross-cultural segment of the U.S. population. 

Like so many organizations, the IHPC is actively responding to the unprecedented tectonic shifts in the country. Unexpectedly, the underpinnings of what gives meaning to our work is being stress-tested, a test that will surely be ongoing for the foreseeable future.  That said, the IHPC’s mission and vision been more relevant, guiding leaders while infusing policy initiatives that will hopefully make a difference for the integrative healthcare industry.

Editor’s note: David Fogel, MD is the chief executive officer and co-founder of CHI Health Care and and at-large board of director and co-chair of the Policy Committee for the IHPC. This article is sponsored by the IHPC.