| 800 south frederick avenue ...€¦ · •hsa-health savings account •fsa-flexible spending...

www.CaseyHealth.org | 800 South Frederick Avenue | Gaithersburg, MD 20877 | 301.664.6464

Started Yoga Practice Age 51

The American Board of Integrative Medicine defines Integrative Medicine as the practice of medicine that:

• reaffirms the importance of the relationship betweenpractitioner and patient

• focuses on the whole person

• is informed by evidence

• makes use of all appropriate therapeutic approaches,healthcare professionals, and disciplinesto achieve optimal health and healing


Casey Health Basic Info:Free Standing, not-for-profit, staff model healthcare center

Integrative Primary Care offering multiple modalities

concierge, membership, consultation model

Hospital or University Affiliated

Commercial Insurance, Medicare, Medicaid

Financial Assistance policy for all services-CAM included (Fed.Pov.Guid.)

Not Federally subsidized

Doors opened: Feb. 2013, zero patients June 2016, 4200 patients

Integrative Health Team

Yoga Therapist (1) Family Physicians (3) General Internist (1) Doctor of Chiropractic (1) Nurse Practitioner (1) Physicians Assistant (1) Acupuncturist (2) Psychologist (2) Naturopathic Doctor (1) Nutrionist (1) Massage/Reiki/Energy (1)

Wellness Center Classes & Workshops

Mindfulness Physicians Kitchen Yoga Yoga Teacher Training Dance/Fitness Stress Reduction aCHIeve Weight Loss Community Night- $5

Yoga, Reiki, Meditation

Casey Health Institute

“Sophisticated Integrative

Patient”

Primary Care PatientLittle or No Knowledge of

Integrative Health

TRUE INTEGRATIVE CARE REQUIRES TEAM BASED CULTURE

TRUST

ACCOUNTABILITY

CARING

TRANSPARENCY

INTEGRITY

LOYALTY

EGALITARIANISM

Regular meetings with entire staff-operations, policy, culture, education….

Front Desk

Billing

Medical Assistants

Nursing

Practitioners

Accounting

Marketing

Wellness

Practice Manager

Executive Team

PHYSICAL LAYOUT-TEAM ROOM

Facilitates Collaboration

Cultivates Communication

Grow high performing teams

Encourages innovation

Refines Coordination

Flatter Org. Structure-Less HeirarchyLeadership prioritizes shadowing, open door

policy, regular communication at all levels of the practice.


Quantum Collaboration

Coordinated collaboration is a highly energizing and unifying process for patients and staff alike

Patients and practitioners LOVE collaborative, team based, multimodality, Integrative care-

Healing power is enhanced when patients are “held” by a high functioning Integrative, collaborative, coordinated, and communicative team-(our experience but not proven)

The whole is greater than the sum of the parts


Yoga Therapy at Casey Health-BASICS:• Iyengar based

• Used to treat a diversity and complexity of medical conditions

• Interwoven throughout the practice

• Considered one of a number of distinct clinical disciplines in our multidisciplinary team approach to health


The Evolution of the Yoga Therapist’s Role at Casey Health

Casey Health opens doors offering an Iyengar based Yoga Therapy Program (2013).Over sight through Unity Woods Yoga Center, John Schumacher, Senior Iyengar

Yoga Teacher. Cumbersome and Impractical.

Evolution of Yoga Therapy Delivery Models: Evaluation of 2-3 new Casey patients/month with John as Senior Iyengar Advisor. Less

cumbersome, still not practical.

On-going patient consultation by Iyengar Certified Yoga Teachers, overseen by John. Getting better but not there yet.

Full time Clinical Yoga Specialist, a salaried employee, with John as Senior IyengarAdvisor. Most practical so far but a work in progress.


Yoga Clinical Specialist Scope of Work in a Primary Care SettingInternal/External ReferralsWeekly Practitioner MeetingsEHR ChartingPractitioner CommunicationFloat SessionsMarketingEducation-internal and externalPounding the Pavement


Patient Flow in the YT Program

• Weekly Phone Consultations –Sequencing Refinement of active patient’s in program and discussion of new patients.

•Follow up Patient visits (60 minutes) – YT F/U Packages of 3, 5, or 7 privates. Graduates to a Home Practice and into YT Group Class or General Class.

• Initial Evaluation with CYS and Patient (90 Minutes).

• Patient information discussion with Referring Provider(s).

Clinical Yoga Specialist

Receives Patient Yoga Therapy Referrals and

Patient Information (Providers and YT Program Forms)

Senior Iyengar Yoga Advisor

Case Discussion/Sequence

Collaboration


Electronic Health Record-Integration,

Charting, Templating,

On-going innovation


Yoga TherapyPrescriptions

ADHO MUKHA SVANASANA – FEET ON BLOCKS AT WALL – DOWNWARD

FACING DOG POSE

Instructions:

Place the short end of the mat at the wall and place 2 blocks against the wall, hip width apart.

Kneel on the mat with your feet close to the blocks, tucking your toes under

Place your hands down, shoulder width apart, about 4 feet from the blocks.

As you exhale, press your hands and feet and lift your hips up and back, diagonally away from

your hands into Downward Facing Dog Pose. Step your feet onto the blocks, one at a time, so

that your heels are against the wall.

Press back with your thighs and press your heels into the wall.

Press your palms evenly, index finger knuckle pressing firmly and stretch your inner arms

straight.

Turn your upper arms from the inner arm to the outer arm, externally rotating your arms. Take

the top of your shoulder blades into your back without poking your bottom frontal ribs toward

the floor.

Sacrum lifting up and back, backs of the thighs lifting from the knees to the buttocks.

Stay in the pose, breathing fully, for 30 to 60 seconds.

To come out: Bend your knees and step off of the blocks. Rest in Adho Mukha Virasana –

Child’s Pose for about 60 seconds, relaxing fully.


Yoga PrescriptionFiles


Internal ReferralsWellness

Prescription Pad


External Medical Referrals


Economic ModelNot covered by insurance

•Creative pricing structures developed over time with Provider feedback

•Pricing Tiers

• Financial Assistance


Wellness Workshops• 1. Mindfulness Meditation – teaching of asana and pranayama as an expert presenter

• 2. Grounding through the Season – yoga to manage the stresses of the holidays

• 3. Meditation in Motion – movement-based yoga series

• 4. Relax & Breathe – restorative yoga class with basic pranayama breath work

• 5. Restoring & Reflecting – yoga for stress management

• 6. Yoga Nidra

• 7. Keep Your Inner Light Shining – using yoga as a tool to deal with seasonal affective disorder and winter blues

• 8. Mind-Body Connection – yoga as a tool to understand and explore the connection between mind, body and spirit

• 9. Yoga and Sleep – using yoga as a tool to improve sleep hygiene

• 10. Calm at Your Fingertips – yoga as a tool for in-the-moment stress response

• 11. Rope Wall Yoga – using rope wall adaptations of yoga poses to access and extend poses

NEW YOGA SHORT COURSES!!

Yoga for Fibromyalgia/Fatigue

Yoga for Diabetes

Yoga therapy sessions at Casey Health involve selecting, modifying and teaching a series of yoga

poses, including breathing and relaxation techniques, to meet our patients’ specific health care

needs. Our clinical yoga specialist works in consultation with your provider to deliver

customized healing yoga sequences to meet your personal needs.

Yoga for Fibromyalgia/Fatigue: Yoga can help to improve a patient’s ability to

cope with pain and fatigue, relax, lessen muscle tension, and improve sleep quality, plus

more. Join Mary Pappas-Sandonas in this 4 week short course to achieve a renewed

sense of calm and balance in your health and in your life. (Single class/ $20, full series/$80. This series runs from 3/4 -3/25/16, 10:00 – 11:30a)

Yoga for Diabetes: We now know a regular yoga practice can help reduce the level of

sugar in the blood, lower blood pressure, keep weight in check, reduce symptoms and

slow the rate of progression of diabetes, as well as lessen the severity of complications.

Join Mary Pappas-Sandonas for this 4 week yoga short course to learn yoga poses and

breathing exercises that address the symptoms of diabetes. Our patients describe these

yoga sessions as restorative, resulting in a renewed sense of calm and balance. (Single class/ $20, full series/$80. This series runs from 3/3 -3/24/16, 10:00 – 11:30a.)

Visit www.caseyhealth.org or call 301.355.2030 to sign up!

Yoga for Digestive Woes A Yoga Short Course at Casey Health

WHAT: 4 Weeks to Digestive Wellness! $20 per class, $80 for four week series

WHEN: Fridays, April 8th – 29th, from 10:00 am – 11:30 am at Casey Health

800 S. Frederick Avenue Gaithersburg, MD

SIGN UP: www.caseyhealth.org or call 301.355.2030

Clinical Yoga Specialist Mary Pappas-Sandonas will guide you

through a series of gentle, low-impact poses to improve the clinical

symptoms and psychological impact of many digestive disorders

such as SIBO, IBS, IBD and other general gut issues.

Class participants do not have to be experienced in yoga –

all are welcome!


Appointment/Pricing Tiers

• Individual Appointments• Yoga Therapy Packages: $399 for 4 sessions, $599 for 6 sessions, $799 for 8

sessions• Individual Yoga Therapy Session: $125• 4 Sessions for $200 (time limited for immersion experience)• 15 for $15

• Group Classes• Short Course Specialty Class Packages and Drop In Sessions: $20/class• Chair Yoga: $18/class• Yoga Therapy Group Class: $25/class

• A taste of Yoga Therapy: Achieve, Mindfulness, SAD, Mood


On-Going Yoga Therapy Classes

1. Chair Yoga

2. Gentle Yoga

3. Therapeutic Yoga – for patients currently under treatment

4. Yoga to support Weight Loss through the aCHIeveprogram


Yoga Short Courses3 or 4 week Intensive Courses

1. Yoga for Backs and Hips

2. Yoga for Neck and Shoulders

3. Yoga for Digestive Woes

4. Yoga for Diabetes

5. Yoga for Fibromyalgia and Fatigue

6. Yoga for Menopause

7. Yoga for Women’s Health

8. Yoga for High Blood Pressure

9. Yoga for Cardiovascular Health


Economic ModelCovered by Insurance

•HSA-Health Savings Account

• FSA-Flexible Spending Account

• Individual contracts with payors

i.e. Evergreen HealthSimilar to Physical Therapy $140-$200 in 15 min. increments

97110 (36.83 x the potential of 4 units= $147.32)- Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to

develop strength and endurance, range of motion and flexibility

97140 (33.90 x the potential of 4 units = $135.60) - Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic

drainage, manual traction), 1 or more regions, each 15 minute

97150 ($19.57 per person)- Therapeutic procedure(s), group (2 or more individuals)


Group Visit/Shared Medical Appointments

1. Yoga and Behavioral Health – Mood Group for Women (approx. $20/patient)

2. Yoga as a tool to support patients in the Diabetes Prevention SMA (approx. $70/patient)


Value Based Care/Population Health

Getting Paid to keep People Healthy• Patient Centered Medical Homes,

• Accountable Care Organizations,

• Shared savings programs,

• Per Member/Per Month,

• Capitation,

• Risk sharing arrangements

Serving Montgomery County and the National Capital Region


Namaste

Thank you

| 800 south frederick avenue ...€¦ · •hsa-health savings account •fsa-flexible spending...

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