Prevent, Protect, Improve
authors Cindy Sanders
When two wellness giants joined forces in 2013, the hope was that millions of people would benefit. Nearly three years later, the partnership between Dean Ornish, MD, and global well-being improvement company Healthways continues to expand, bringing evidence-based lifestyle programming to ever-increasing numbers of individuals across the nation.
Based in Franklin, Tenn., Healthways is a provider of well-being and health improvement solutions to nearly 68 million people on four continents. The company entered into an exclusive agreement with Ornish in July 2013 to operate and license his Lifestyle Management Programs, which included interventions addressing early-stage prostate cancer, type 2 diabetes, and heart disease.
A cornerstone of the partnership is Dr. Ornish’s Program for Reversing Heart Disease™ (Ornish Reversal Program), which is scientifically proven to not only treat … but also to reverse … the progression of heart disease through comprehensive lifestyle changes.
“What’s different about it is recognizing lifestyle is a viable treatment alternative for cardiac disease that can actually reverse the disease at its root cause,” said Robert Porter, managing director of the Ornish Reversal Program for Healthways.
He added integral parts of the program focus on diet and nutrition, exercise, stress management and group support. “One of the unique things about the program is that it is offered to people in cohorts of eight to 15,” Porter said. “The reality is we are social animals. We’ve discovered the power of that group support and community in helping individuals make and sustain a behavior change.”
Each small group participates in 18 four-hour interactive sessions. In addition to learning new strategies and techniques from a staff leader, participants also use group time to share suggestions and practical solutions to incorporating new habits into daily ‘real’ life. During a session, the group might share a meal, practice yoga together, work on stress reduction exercises and learn how to choose wisely from restaurant menus. “They don’t just learn what they should do … they actually do it,” Porter said. “They’re actually living the program during those 18 sessions.”
He pointed out the support system functions in much the same way as having a workout buddy, mixing social interaction with a degree of accountability. “It’s a really powerful way to provide support, a bond and a covenant among the group that helps them build (program elements) into their new lifestyle,” he explained.
Porter added the bond is so strong that participants formed alumni groups to continue to foster encouragement and maintain interaction. The Ornish Reversal Program website (ornishspectrum.com) states 87.9 percent of participants continue to get together regularly after finishing the 72 hours of active programming. In fact, Porter noted, some of the participants from the early research studies, which go back decades, continue to keep in contact.
“Dr. Ornish, over 30 years, has done the most rigorous research you can imagine,” Porter said of the science behind the program. Starting with the notion that it’s easer to turn off the faucet than to mop up the floor, Ornish began formulating ideas about how to improve health while he was still in medical school. By 1978, Ornish and colleagues at the University of California, San Francisco showed heart disease could be reversed after only 30 days, as demonstrated by improved blood flow to the heart, in a pilot study that utilized the tenets of the Ornish program.
Based on nearly four decades of ongoing research, which has been widely published in peer-reviewed journals, the program was approved for Medicare reimbursement under the category of ‘Intensive Cardiac Rehabilitation’ beginning in 2011. In addition to nationwide reimbursement through Medicare, commercial payers in 17 states also cover the program for heart disease.
“As the evidence grows, as we gain experience, the science would seem to predict there is the possibility for this program to expand to a larger number of chronic diseases,” said Porter. He added a few payers have extended the criteria for coverage to include those with diabetes and early-stage prostate cancer.
The core program, however, is currently focused on heart disease. With the exception of congestive heart failure, which Porter said he hopes will be added in the near future, the program is approved under Medicare for the same diagnoses as traditional cardiac rehabilitation. The six qualifying conditions are:
- Acute myocardial infarction in the preceding 12 months,
- Coronary Artery bypass surgery,
- Current stable angina pectoris,
- Heart valve repair or replacement,
- Percutaneous transluminal coronary angioplasty or coronary stenting, and
- Heart or heart-lung transplant.
A focus on lifestyle modification and prevention has increasingly become more mainstream in healthcare, but transforming the delivery system remains an ongoing challenge.
Phil Newbold, CEO of Beacon Health System in Indiana, which launched the program in August 2015, noted, “If you look at the mission and vision statements of most hospitals and health systems, the word ‘health’ is all over them … but if you look at where we spend our resources, about 99 percent goes to the medical side of things and very little actually focuses on health. When we looked at the Ornish Reversal Program, we saw that it was the best way for us to really embrace health in a scientific way and better align ourselves with our mission of creating a healthier community.”
Echoing the sentiment, Porter said, “I think our whole healthcare system was built around passively waiting to treat people when they presented with a problem. We’ve found that is unsustainable. It’s unsustainable financially, and we’re not optimizing the health status and qualify of life for people.” He continued, “The best way for us to promote health is to adopt a healthy lifestyle that prevents the onset of chronic disease.”
The Ornish Reversal Program is rapidly gaining a foothold in the medical community since rolling out nationally about 18 months ago. At the end of 2015, four new partner sites were announced in Texas, Florida, North Carolina and Virginia. At press time, Healthways had implemented the program in 22 sites across 14 states with two more programs in the process of being launched and numerous others in the discussion phase.
While Porter said it was too early to have hard financial figures in terms of savings to the health system, he noted early indicators have been impressive. “We’re certainly seeing incredibly solid clinical results,” he said. “Based on those clinical results, the predictive variables would indicate we expect to see solid results in other outcomes like readmissions and costs.”
Physician groups and hospitals interested in learning more about the program and research behind it should go online to ornishspectrum.com or call Healthways at 877-888-3091.
Preventive Medicine Research Institute
Ornish Reversal Program