Lifestyle Medicine and Economics: A Proposal for Research Priorities Informed by a Case Series of Disease Reversal.

Kara A Livingston,David Drozek,Kelly J Freeman,Jamie Shallow,Dexter Shurney,Padmaja M Patel,Susan M Friedman,Kathryn J Pollard,Ron W Stout,Kaitlyn R Pauly,Liana S Lianov,Thomas M Campbell,Micaela C Karlsen

doi:10.3390/ijerph182111364

Abstract

Chronic disease places an enormous economic burden on both individuals and the healthcare system, and existing fee-for-service models of healthcare prioritize symptom management, medications, and procedures over treating the root causes of disease through changing health behaviors. Value-based care is gaining traction, and there is a need for value-based care models that achieve the quadruple aim of (1) improved population health, (2) enhanced patient experience, (3) reduced healthcare costs, and (4) improved work life and decreased burnout of healthcare providers. Lifestyle medicine (LM) has the potential to achieve these four aims, including promoting health and wellness and reducing healthcare costs; however, the economic outcomes of LM approaches need to be better quantified in research. This paper demonstrates proof of concept by detailing four cases that utilized an intensive, therapeutic lifestyle intervention change (ITLC) to dramatically reverse disease and reduce healthcare costs. In addition, priorities for lifestyle medicine economic research related to the components of quadruple aim are proposed, including conducting rigorously designed research studies to adequately measure the effects of ITLC interventions, modeling the potential economic cost savings enabled by health improvements following lifestyle interventions as compared to usual disease progression and management, and examining the effects of lifestyle medicine implementation upon different payment models.

Highlights

Chronic disease places an enormous economic burden on both individuals and the healthcare system
The objective of the quadruple aim is to optimize health system performance through improved population health, improved patient experience, reduced healthcare costs, and provider well-being [58]. This case series illustrates the effectiveness of intensive, therapeutic lifestyle change (ITLC), utilizing a predominately WFPB diet, in many cases coupled with physical activity, to promote the remission of chronic disease and decrease the need for medication, supporting all four components of the quadruple aim
This case series illustrates dramatic improvements in physical health and quality of life resulting from lifestyle change, a transition to a WFPB diet

Summary

Introduction

Chronic disease places an enormous economic burden on both individuals and the healthcare system. Existing fee-for-service models of healthcare prioritize symptom management, medications, and procedures over treating the root causes of disease through changing health behaviors [1]. The U.S health system faces major challenges to contain.

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