Shared Medical Appointments Can Lower Costs and Improve Outcomes

Shared medical appointments (SMAs) for chronic health conditions have been around since the late 1990s but only recently have they been examined as a means of delivering functional medicine-based care.

In a new study published in BMJ Open, researchers at the Cleveland Clinic compared outcomes and costs of a 10-week SMA program with individual functional medicine care. It was found that SMAs are an efficient and cost-effective way to deliver functional medicine care for common chronic conditions via a collaborative care team.

Researchers concluded that after three months both groups showed improvements in health-related quality of life and biometrics, but the SMA patients had greater improvements in patient-reported physical and mental health scores and lost more weight than those receiving individual care.

The 10-week SMA program, called Functioning for Life (FFL), uses tools from the Institute for Functional Medicine—a partner organization of the Cleveland Clinic. The program covers five cohorts: weight management, autoimmune disorders, digestive disorders, women’s health, and diabetes. Multidisciplinary teams provide education on nutrition, lifestyle, and behavioral health, with a goal of empowering patients to make healthy food and lifestyle changes and choices.

The study included 2,455 patients—226 SMAs and 2,229 individual appointments. Both groups reported lower blood pressure and weight loss, although SMAs had significantly greater improvements in weight loss than the individuals group. The groups showed equal improvement in blood pressure. SMA patients had significantly greater improvement in PROMIS Global Physical Health T-scores than individual patients.

Despite the fact that SMAs cost less to deliver and generated greater revenue, SMA patients received more caregiver time per patient than those having individual appointments.

It was also found that SMAs provided more opportunity for interaction with care team members and for patient education—one of the most time-consuming elements of individual functional medicine visits—than traditional care. SMAs eliminate the need for practitioners to repeat the elements of diet, lifestyle, and behavior change to patients individually, as this moves to a group setting.