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ACOEM calls for integrating workplace health with ACO/PCMH concepts

ACOEM suggests that a wide range of current infrastructure resources in the workplace could be leveraged to dramatically extend the impact of PCMH and ACOs
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From the ACOEM media release:

The American College of Occupational and Environmental Medicine (ACOEM) has published a position statement suggesting that two new trends in medicine -- accountable care organizations (ACO) and the patient centered medical home (PCMH) -- will benefit by integrating them more closely with workplace health programs.

In a paper published in the April issue of the Journal of Occupational and Environmental Medicine (JOEM), ACOEM leaders suggest that physicians with expertise in workplace health can help extend the influence of ACO and PCMH concepts -- which focus on team-based care and better patient outcomes -- to millions of American workers and their families.

The paper is titled "Optimizing Health Care Delivery by Integrating Workplaces, Homes and Communities: How Occupational and Environmental Medicine can serve as a vital connecting link between Accountable Care Organizations and the Patient Centered Medical Home."

"In order for ACOs and PCMH to succeed in the long term, all sectors with a stake in health care will need to become better aligned with them -- including the employer community, which remains heavily invested in the health outcomes of millions of Americans," said lead author Robert K. McLellan, MD, a former president of ACOEM.

"Occupational and environmental medicine (OEM) provides a well established infrastructure and parallel strategies that could extend the impact of ACOs and PCMH," he said. "The workplace is where millions of Americans spend a major portion of their daily lives, and it makes good sense that it should be an essential element, next to communities and homes, in an integrated system of health anchored by the PCMH and the ACO concepts."

ACOEM's position statement explores the potentially powerful connection between the OEM community in the United States, accountable care organizations and the patient centered medical home, outlining the key points of intersection between the three.

Features of employer-sponsored health services that are essential to and complementary with those available in PCMH and ACOs are highlighted in the position statement, along with opportunities to integrate OEM services more fully into the PCMH/ACO model to make it more effective.

A wide range of current infrastructure resources in the workplace are also highlighted -- resources that could be leveraged to dramatically extend the impact of PCMH and ACOs. These range from a well established infrastructure for supporting health-behavior change (employee-benefit design, workplace incentive-programs, and social reinforcement mechanisms) to employer-sponsored health innovations such as exercise facilities, workplace nutrition programs, and worksite clinics delivering urgent and sometimes primary care in addition to occupational health services.

In recent decades employers have become increasingly proactive as providers of programs and initiatives aimed at keeping their workforces healthier. A growing body of research shows an inextricable link between the health of the workforce and the productivity of the workforce, and enlightened employers are taking steps in response. From disease prevention programs to on-site and near-site health clinics staffed by a spectrum of health care personnel, they are becoming a more and more influential part of the healthcare equation.

ACOEM's paper argues that the promise of the team-based and holistic approach to health in the PCMH/ACO models can only be fulfilled if primary care and public health efforts are linked with current efforts to create healthier workplaces.

"The workplace is organically connected to the home and to the physical communities in which workplaces exist," the authors write. "Individuals do not leave the impacts of their personal health risks on the doorstep when they leave for work just as they cannot leave the impacts of their workplace exposures when they return home. Health behaviors extend across multiple environments and cannot be artificially separated."

Because health in the workplace, health at home and health in communities are interconnected, workplace health initiatives are uniquely positioned to leverage the coordinated health and productivity enhancement strategies that are a fundamental goal of PCMH and ACOs, the position statement asserts.

In addition to Dr. McLellan, authors of the position statement include Bruce Sherman, MD; Ronald R. Loeppke, MD; Judith McKenzie, MD; Kathryn L. Mueller, MD; Charles M. Yarborough, MD; Paul Grundy, MD; Harris Allen, PhD; and Paul W. Larson, MS. To read the statement in its entirety, visit the link.

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