Lifestyle Medicine Insider
May 2019 | Second Edition
Lifestyle Medicine Insider , a periodic look into the political, industry and economic environment we face as an organization of Lifestyle Medicine pioneers under President Dexter Shurney’s priorities:

  • Policy
  • Payment
  • Partnerships
  • Public Relations
  • The 2019 ACLM Member Survey revealed that members believe reimbursement to be the biggest barrier to successfully practicing Lifestyle Medicine. As mentioned in the first issue of Insider, ACLM has engaged Washington, DC, policy and advocacy professionals Alston + Bird to help us tackle the policy changes in quality measures, coding and EMR for successful reimbursement for all LM practitioners.

  • ACLM’s Reimbursement Member Interest Group is drafting a comprehensive Roadmap for Reimbursement, and, in the meantime, will soon issue an interim document on the ways members may currently seek reimbursement for practicing LM in the existing fee-for- service model.

  • Revamping IDC -10 codes will be the first step in getting paid for LM services. While HHS, CMMI and CMS just announced the Primary Cares Initiative with some changes to Medicare Advantage coding “to transform primary care” that may bode well for LM, it may be some time before health plans use those codes for reimbursement (health plans are just now recognizing Diabetes Prevention Program codes and they came out in 2015). But the announcement’s focus on rewarding value-based outcomes in primary care is a hopeful signal that there is movement in the right direction.
  • The National Board of Medical Examiners (NBME) has no LM questions on medical board exams. Like any school, medical schools teach to the test. So, in 2018, the American College of Lifestyle Medicine, True Health Initiative and Food Revolution Network joined forces to petition the NBME to add whole foods nutrition-related questions to the question bank provided to medical schools. Dozens of the most distinguished medical authorities in the United States signed on. As a result, NBME responded with acceptance, and a challenge. They said that if we create suitable questions, written by qualified professionals – they will add them to the question bank. To do so, funds are needed to hire the qualified authors to develop these questions according to NBME guidelines. The plan is to produce a 1,000-question bank that will live with ABLM that medical schools can use as part of their categorical assessment tests. Once 75% of med schools use questions from the bank for these assessment exams, it will evidence interest and force NBME to include questions on board exams. We are helping raise $250,000 to accomplish this goal. That’s $250 per question, for 1,000 qualified and evidence-based questions to be added to the NBME question bank.
  • From the ACC/AHA in its recently released Guidelines on the Primary Prevention of Cardiovascular Disease:  “All adults should consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, processed meats, refined carbohydrates, and sweetened beverages.

  • The True Health Initiative has announced publication of its new protein quality metric paper in the May 8 Advances in Nutrition. The paper redefines protein quality based on current scientific evidence and adapts this new definition into a metric that can be applied to national food regulatory and labeling systems. The paper outlines why our current definition of protein quality is obsolete, inaccurate and harmful to both human and planetary health.

  • A new study has been published in the Clinical Journal of the American Society of Nephrology on the positive effects of plant-based eating for those with chronic kidney disease (CKD). 

  • The Chief Wellness Officer of Delaware’s Christiana Care Health System provides insights on provider burnout efforts in creating a culture of wellness.
  • Lifestyle Medicine pioneers and ACLM members at Midland Health and its Lifestyle Medicine Center in Midland, TX, highlighted in this ACLM Story Project videocontinue to make a difference for patients. Midland County has moved up to the 29th healthiest county in Texas out of 254, according to this year’s County Health Rankings from the Robert Wood Johnson Foundation. The 2018 report had Midland County in the No. 42 spot. The rankings are based on length of life and quality of life.

  • As an addendum to last issue’s spotlight on Lifestyle Medicine efforts in Brooklyn and New York City, here are further details on programs hospitals and their partners around New York are creating that encourage healthier, more local and sustainable food and promote good health both inside and outside the hospital.

  • In addition, New York City Mayor Bill de Blasio announced the details of a “Green New Deal” to phase out purchases of processed meats and cut purchases of red meat by 50 percent in its city-run facilities and public schools by 2040. New York City would become the first city in the country to adopt a policy phasing out purchases of processed meat. This commitment to meat reduction builds on the recent adoption of Meatless Monday by all NYC schools.