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

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.

Oxidative Stress in the Pathogenesis of Aorta Diseases as a Source of Potential Biomarkers and Therapeutic Targets, with a Particular Focus on Ascending Aorta Aneurysms

“…It is estimated that in 2030, the percentage of incidence will achieve the value of about 40.5% [ 1 ]. Thus, CVDs constitute a strong challenge to public health [ 2 ]. However, progress has been achieved in the management of some CVDs.…”

Correlation of lipid profile in diabetes patients

“…As a result, medications for lowering lipid may be postponed till glycemic control is reached and a clearer representation of lipid pattern for patient is developed. (18) The link between higher ESR, LDL cholesterol, and lower HDL cholesterol may indicate low-grade inflammation causing cardiovascular risk. (19) Higher TG levels were linked to increased total leukocyte counts.…”

A Rationale and Framework for Activating Employers as Agents of Change in the Implementation of Lifestyle as Medicine

“…"Together, we must work to identify the social determinants of health; target prevention through multiple channels by identifying the intersections of various diseases; use data to understand the individuals and the populations we serve; be diligent about removing implicit bias and structural barriers; and harness technology to move health care from episodic, siloed 'sick care' to continuous and integrated 'healthcare'". 10 Preliminary studies 9,11,12 and systematic reviews 13 have demonstrated the effect of lifestyle medicine interventions. Dr. Richard Safeer provides a case study from Johns Hopkins Medicine later in this issue that describes a very compelling example.…”

“…Preliminary studies 9,11,12 and systematic reviews 13 have demonstrated the effect of lifestyle medicine interventions. Dr. Richard Safeer provides a case study from Johns Hopkins Medicine later in this issue that describes a very compelling example.…”