INHE 3001 Week 3 Model Comparison Example

Four Criteria Fixed First, Three Models Second: A Comparison of Employed, Co-Located and Referral-Network Integrative Services That Favors One Model on Two Counts and Fails It on Two

Student Name

Walden University

INHE 3001: Integrative Health Care Models

Instructor Name

Month Day, Year

Four Criteria Fixed First, Three Models Second: A Comparison of Employed, Co-Located and Referral-Network Integrative Services That Favors One Model on Two Counts and Fails It on Two

The Criteria, Fixed Before Any Model

Four criteria were written down before any model was described, so that no criterion could be shaped to suit a favorite. First, built-in coordination: whether the arrangement itself makes conventional and complementary clinicians share information, rather than leaving it to goodwill. Second, cost to the patient: what a patient typically pays out of pocket per session. Third, funding durability: whether the service could survive the loss of any single funding source. Fourth, scope fit: whether practitioners work within licensure and supervision rules without workarounds. Each model is rated strong, mixed or weak on each criterion, with a reason.

The Three Models

Model A is an employed service: the hospital or health system employs complementary practitioners, books them through its own scheduling system and records their work in its health record, like the oncology service described in Week 1. Model B is co-location: independent practitioners rent space inside a primary care building, keep their own records and bill patients directly. Model C is a referral network: a clinic keeps a list of vetted community practitioners and refers patients out.

These sit at different points on a continuum described in a widely used framework, from parallel practice, where clinicians work side by side without integration, through consultative and collaborative arrangements to fully integrative teams (Boon et al., 2004). Model A sits nearest the integrative end, Model C nearest the parallel end.

The Ratings

Table 1

Three delivery models rated on four criteria fixed in advance

Ratings are the author's judgments from the model descriptions above and the sources cited; they are not drawn from a single organization's data.

The Conclusion

Model A is the strongest choice on two of the four criteria, built-in coordination and scope fit, because employment puts practitioners inside the same record, scheduling and credentialing systems as conventional staff. It fails on the other two. Patients often pay out of pocket because many complementary services are not reimbursed, and the service depends on whoever pays for unreimbursed sessions. The VA's Whole Health System shows that an employed model can avoid both weaknesses when complementary approaches are written into the benefit itself (Bokhour et al., 2020), but few private systems have made that commitment.

What the Split Verdict Means

No model wins on all four criteria, and the comparison does not pretend otherwise. A health system choosing among them is choosing which weakness it can manage. Evidence on cost is thin: a systematic review of economic evaluations found that most studied single therapies, and only one compared usual care with usual care plus access to several licensed complementary practitioners (Herman et al., 2012). An organization drawn to Model A for its coordination should plan its funding before launch, since the comparison suggests funding, not clinical fit, is where employed services are most likely to fail.

References

Bokhour, B. G., Haun, J. N., Hyde, J., Charns, M., & Kligler, B. (2020). Transforming the Veterans Affairs to a Whole Health system of care: Time for action and research. Medical Care, 58(4), 295-300. https://doi.org/10.1097/MLR.0000000000001316

Boon, H., Verhoef, M., O'Hara, D., & Findlay, B. (2004). From parallel practice to integrative health care: A conceptual framework. BMC Health Services Research, 4, Article 15. https://doi.org/10.1186/1472-6963-4-15

Herman, P. M., Poindexter, B. L., Witt, C. M., & Eisenberg, D. M. (2012). Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations. BMJ Open, 2(5), Article e001046. https://doi.org/10.1136/bmjopen-2012-001046