Rising Healthcare Costs: Has Anyone Tried Wellness Programs to Cut Expenses?

I'm curious: Has anyone implemented any wellness or other program to address (reduce) rising healthcare costs?

Dear friend,

Namaskar.

In material terms, my answer to your query is emphatic "yes". To be safe, in the preceding 5 years, my medical expenses are NIL. My morning exercise (physical and mental) group, which I started about 6 months back, is gradually realizing how it is possible.

If you or anybody has any free association, then everyone is welcome to ventilate.

Regards,
Jogeshwar

Hi,

SHRM conducted research on rising healthcare costs and the strategies companies are implementing to curb them. Many organizations have incorporated wellness programs as an approach to manage cost escalation. Even insurance providers are nowadays emphasizing wellness. Kaiser was recently featured on NBC Nightly News for their wellness initiatives and how they controlled costs with that initiative.

Thank you.

Dear Rajnish,

Namaskar.

I think my post above is somewhat misplaced. I realized it later. Your post gives opening information. Will you please elaborate on the following points?

1. Names of the companies,
2. Detail programs,
3. Since when the programs are ongoing, and
4. Cost-effectiveness if determined.

Regards,
Jogeshwar

While wellness and preventative programs (blood pressure testing, diabetes screening, smoking cessation, etc.) are to be applauded, healthcare cost containment rests with the employee and dependents.

Currently, in the US, healthcare providers are looking at High Deductible Health Care Plans (HDHP). The plans require a high deductible ($1000/individual; $2000/family) with even higher "out of pocket" requirements ($5000/individual; $10000/family). As a result of the higher "pass-through" costs to the consumer (employee), the company will realize a significant reduction in premiums, some of which can be rebated to the employee MSA. For their part, consumers (employees) can establish Medical Savings Accounts (MSA) contributing $2250/individual; $4500/family (additional contributions can be made by employees 55 and older). Contributions to MSA are tax-deductible on the Federal tax return.

Additional benefits of the MSA include:

Portability: Take it along as one moves from job to job.

Vesting: 100% to the consumer (employee). Different from old "cafeteria" plans where the employee had to use the funds deposited or forfeit them.

Growth: Annual contributions plus interest/dividends.

Flexibility: MSA dollars can be used to pay for a variety of "medically related" expenses. Penalties are assessed if money is used for other than "medically related" expenses.

These plans place responsibility on the consumer (employee & dependents) to use the plan prudently, as well as to encourage exploration and utilization of relevant preventative programs.

Dear Paladin,

Namaskar.

From the above, it appears that the company does not provide relevant preventive programs. In that case, it may be difficult to strike a balance between life and livelihood. Are there companies that provide relevant preventive programs as Rajnish says? Do the companies allot time for such health practices?

Regards, Jogeshwar

Jogeshwar,

I will look over the report I have at home to see if I can pass on names and details of companies who have adopted a wellness program. There has been a major inflation in insurance costs post-2001, and companies are looking at creative ways to curtail that cost. Many companies have stopped subsidizing insurance premiums, some do a split; however, with a talent shortage projected for the next couple of years, companies are looking at creative ways to manage insurance programs to provide maximum benefits to employees. Wellness initiatives are a part of these efforts; most provider websites now have links to common problems such as blood pressure, diabetes, and stress, emphasizing the importance of an annual check-up. They also post health-related information mailed periodically, emphasizing the importance of preventative care.

Raul and Ranjnish:

You both make excellent points.

Raul, I see some problems with an hourly-based contract for a healthcare provider, especially if you are referring to a medical doctor.

- Are you willing to guarantee a number of hours?
- Where will the employee be seen? Who pays the cost of travel?
- What will you pay for fractional segments (less than an hour)?
- Will you be willing to pick up the administrative costs, i.e., recordkeeping and billing?

I think there are other ways to implement wellness programs that are almost cost-free. For example, the Blood Bank will do blood pressure screening for employees and dependents when they donate blood. (The Bank will be glad to send a van to your location). The Diabetes Association will do screenings.

Contact local healthcare agencies for guidance, support, and contacts. If you have a Plant Nurse, he/she should have some ideas.

In addition to providing preventative programs (forgot to mention annual checkups, thanks Rajnish), also consider subsidies for health club membership, or set up a small "workout room" in the facility which should be accessible to employees and dependents. {Check with legal to ensure that the company is not exposed to any liability in the event an employee/dependent is hurt in the "workout room". Membership based on dues of $1.00/year for each participating member may be the best route.}

Furthermore, you could send press releases to local news media to publicize the Company's efforts to hold down healthcare costs, thereby demonstrating that the company is considerate, compassionate, and responsive to employee needs, as well as being a responsible member of the community.

Dear Raul,

"One bird does not make a spring." I think this was on your mind when you initiated this thread.

Dear Rajnish, Bill, and Raul,

I think the discussion is becoming lively.

Regards,
Jogeshwar

Bill,

I'll try to answer the questions you raised:

Nurse Practitioners are used to staff onsite clinics, and each NP is supervised by a physician. Yes, hours are pre-set, and each location has a predetermined schedule that employees can count on. The hours are determined by the number of employees (or program participants, as spouses sometimes also utilize the clinics). Our current fee-for-service system has too many built-in incentives for overutilization. In order to control costs, one must move away from the mentality of getting more money for more service. Contracting for a set, hourly rate eliminates money from the equation and allows practitioners to focus on medical delivery and quality, not on how many patients they "produced" in a given hour (this is key). The wellness program headquarters is responsible for monitoring that NPs are following the prescribed course of action, as well as making sure that program participants are COMPLIANT. What does that mean? It means that each is doing whatever they need to be doing to keep their chronic conditions in check.

Onsite is important. We have found that convenient access is another key factor to success. Many employees don't seek help PRECISELY because it's very inconvenient to take 3-4 hours off for what's considered a "minor problem that might soon go away." The companies that are more likely to be able to take advantage of this have 250 employees or more per location (4-8 hours of clinic per week). There are other options for smaller groups, but a bit lengthy to go into here.

Another important motivator for program participation is that employees can access primary health care, get prescriptions filled, all at zero cost to them. Remember that traditional Managed Care organizations have been preaching LIMITING services as a way of saving money. Our belief is completely the opposite: making quality primary care available to those with chronic conditions is many, many times cheaper than waiting for them to hit an Emergency Room. There are multiple "tricks" to get the whole thing to work. Some of the elements are:

1) The program needs to be incorporated into the benefits structure of the company.

2) Very specific protocols need to be outlined for the practitioners.

3) Employees need to be strictly monitored for compliance - incentivized or disincentivized to do so.

4) Clear reporting mechanisms need to be in place to keep management informed (HIPAA compliant, of course).

The problem with your ideas of getting free things here and there is that YES, one would think they make sense - but the bottom line is that few will use them, and there is no control over it (standardization). Only by impacting a sufficiently large segment of the chronic risk group will there be hope to make a significant impact on rising healthcare costs - just helping a few individuals here and there isn't enough.

RR

Health care/Medicare/welfare vs. Wellness

Health care/Medicare/welfare measures by an employer for their employees are conventional and known in general. The cost is either adjustable with the remuneration of the employees, contributory, or forms part of the terms and conditions of employment. The employee in such a conventional arrangement is only a beneficiary and not expected to do anything.

Whereas wellness is a new concept, and the employee will have to take part all along. Wellness refers to soundness in mind, body, and spirit resulting in increased comfort and competency. So by definition, it appears attractive, but going about it is not that easy. It requires knowledge, initiation, and practice. In the first two levels, involvement of both the employer and employee is necessary, but in the last level, the employee will have to go by themselves.

Wellness has three components: Appropriate cognition, physical exercises, and nutrition. Appropriate cognition refers to the right attitudes, healthy thoughts, and an inclination for healthy lifestyles. The major techniques are guided imagery, affirmations, right meditations, biofeedback, and hypnosis. All these techniques are curative, preventive, and enhancers of a sound mind, body, and spirit.

Physical exercises of one kind or another are known to all, but unless one acquires the proper mental predisposition, they will not engage in any physical exercises. The most common physical exercises are yogasanas, pranayama, aerobics, and neurobics.

The body requires proper nutrition to be fit. To prevent unhealthy and unhygienic food intake by their employees, I think certain companies provide cooked food to them. Of course, that food may be prepared with the advice of nutritionists.

So, I think wellness discussions should be differentiated from conventional health care/Medicare/welfare measures.

Regards,

Jogeshwar

Dr. Jogeshwar,

You make a very interesting point. After reading your thoughts, I realized that people from all over the world are participating in this discussion. When first initiated, this topic was directed to a North American audience. Let me explain: The US government only pays for healthcare costs associated with people who are over 65 and have contributed for a certain number of years into a fund (social security). Anyone NOT yet 65 is on their own. Therefore, businesses have been primarily responsible for paying the medical costs (i.e., insurance) for their workers. (In most other countries, healthcare is handled by the government.) Healthcare costs have been steadily rising here - due to several factors - and will soon represent 50% of the total cost of a worker. In other words, healthcare will quickly become a more important cost than salary. The "wellness" I have been referring to relates to practical, onsite solutions for American businesses looking to stave off the increasing burden of healthcare - not the spiritual one you refer to. YES, you are correct in what you say, but that will not resolve the urgent need American companies have today.

Dear Raul,

For the same reasons you mentioned, "Heal Thyself" is the motto in mind-body medicine.

Regards,
Jogeshwar

Dear Dr.,

I don't disagree - you are correct. The problem is that if people had the fortitude of "healing thyself" in the first place, 50% of the problem would go away!

Example: in the USA, obesity happens to be an epidemic. It causes diabetes type 2 in over 18 million people. The expenses associated with this (preventable) issue are huge (billions) and is just one example of what I'm referring to.

My point: American companies need to have a program with clear INCENTIVES and DISINCENTIVES for participation and compliance. If left voluntary, people will continue down the same path.

RR

Dear Raul, Namaskar.

Be sure, I am talking about science and not fiction. There are scores of alternative/complementary medicines being experimented with all over the world. The National Institute of Health has a well-structured center for alternative/complementary medicines, established for the sole purpose of reducing treatment costs. Over time, some of these alternative/complementary medicine techniques may disappear, but many of them will evolve and improve.

My focus is on mind-body medicine. The fundamental principles of mind-body medicine are as follows:
1. The body has the capacity to generate far more chemicals than currently known by science.
2. Optimal levels of essential chemicals are required for good health.
3. The body not only deteriorates but also has the ability to regenerate.

My goal is nothing less than 100%. As I mentioned in my initial response, for at least the last five years, I have had no medical bills. Achieving this requires knowledge, commitment, and practice.

Regards,
Jogeshwar

Dear friends,

Namaskar.

May I conclude it now? We have two paths to health:

PATH NO.1

Heal thyself.

PATH NO.2

Baidyaraja namastubhyam,
Yamaraja sahodara.
Yama harati pranani,
Baidya harati dhanani, pranani cha.

English Translation:
Oh master of physicians,
The uterine brother of the god of death,
I bow down before you.
God of death robs off life,
Physician robs off wealth and life both.

PATH NO.3
Does not exist.

Regards,
Jogeshwar.

Raul:

I think we agree in principle that wellness programs are beneficial to the consumer (employee/dependants), and the provider (employer). Where we disagree is in the application of the program.

Some background: Before becoming a consultant, I worked in a "rust belt" industry - Manufacturing plant (metal casting/machine shop environment); 450 hourly employees, 3 shifts, 5-6 days/week.

Full time RN on staff/on site daily, (except Saturday), dispensing minor medication, providing a compassionate ear and responding to accidents as needed.

Part time MD, one day/week. Function: to “clear” employees to return to full time, unrestricted duty; also respond in the event of a serious accident as well as follow-up on Worker Comp cases. In addition, he provided guidance to, and answered any questions the RN had.

RN had contacts with various agencies in the county (Blood Bank, Lung Association, Diabetes Association, and others), and used them to establish a wellness program without a “wellness program headquarters”. As a result of the various agencies' response (they brought their own vans filled with testing equipment) a significant number of employees found they had chronic conditions - high blood pressure, diabetes, the beginnings of emphysema, etc. Those cases were referred to their personal physician for follow up and treatment as determined by the doctor. The RN, with the employee's voluntary permission and in compliance with the privacy rules at that time, monitored compliance with face to face consultation/ reinforcement/ tracking on a regular basis.

The program was so well received that the following month, on a Saturday, we did the same thing for dependents.

The system that you pooh- poohed as “few will use them and there is no control over it (standardization)…just helping a few individuals here and there isn't enough.” WORKED and WORKED WELL. My directive was to get maximum utilization from available resources.

In your reply on 5/13/05, I read an idealistic scenario. Such a plan is impractical, unrealistic and cost-inefficient. Savings realized from wellness are spent on non-productive bureaucratic structures, administrative/professional fees and costs related to furnishing/supplying the clinics. Don't know what industry you are in but from your view on how a wellness program works (or should work), they must be making money hand over fist.

* What is reasonable hourly rate for NP? For MD?

For Wellness Program Headquarters personnel?

* “hours are pre-set”…”determined by the number of

employees (or …spouses {and dependants}…also utilize the

clinics)”.

Does consumer make appointment?

With whom? The clinic or the Wellness Headquarters?

What happens when consumers (employees/

dependants) overwhelm the clinic and staff?

Assembly line care, half-hearted consultation, hap-

Hazard diagnosis, erroneous conclusions and wrong

meds? OR extraordinary waiting time?

* “wellness program headquarters is responsible for

monitoring that NP's “

Isn't that the function of the MD?

Who is monitoring NP - Administrative personnel?

Bureaucrat? NP? MD?

* “We have found“…Many employees don't seek help

PRECISELY because it's very inconvenient to take 3-4 hours

off for what's considered a "minor problem that might soon

go away".

Who is “we”?

How were conclusions “found” ?

In surveys done for the High Deductible Healthcare Plan

(HDHP), statistics show that consumers are more prudent

and selective when spending their own money, then they

are when having the blank check of unlimited medical

coverage. In the past, when “little Johnny, or Jeannie” had

a sore throat, a “home remedy”, or non-prescription over

the counter medication was given. Today, parents are

taking their children to the doctor for "minor problems

that might soon go away".

* “important motivator to program participation is that

employees can access primary health care, get prescriptions

filled, all at zero cost to them.”

I would like to hear more details regarding the “cost

Free” health care and prescription plans.



* “traditional Managed Care organizations have been

preaching LIMITING services as a way of saving money. "

In the past, I have negotiated with Managed Care

Organizations (MCO) and set the terms and conditions

of service. As they solicited our business, I informed

them of the parameters I was seeking - “as needed,

reasonable diagnostic tests, etc.” If they didn't like it,

they didn‘t arrange for a presentation. You would be

surprised at the number of MCO's that wanted the

business bad enough to be willing to design a program

that would save us money in the long run. To

paraphrase one of your points -

It's cheaper to prevent than treat an illness.

Remember, you have the money and they want what you have.

Wellness programs are not about “making quality primary care available to those with chronic conditions”. It is about identifying the problems, counseling and encouraging life style changes - more exercise, quit smoking, eat healthy, etc. It is also incumbent on the consumer to take responsibility for his/her actions and judiciously utilize the health benefits provided by the employer.

We don't need “…multiple "tricks" to get the whole thing to work“; “tricks” are what got us into this situation. We simply need caring professionals who are willing to help consumers uncover, recognize and treat their chronic conditions while supporting them with personal concern and encouragement. Word of mouth will do the rest.

To Dr. Mahanta:

You make some excellant points regarding spirituality/ faith as it is applied to disease/illness. How many times have we heard physicians and other care givers proclaim "It's a miracle!!!"

Bill,

I has happy to read your response and the intelligent issues you raised – it's much easier (and more fun) dealing with smart than dumb. I'll try to respond in kind and address your points. SOMEBODY has to direct the orchestra, but If you can get someone in the organization to take charge and manage any program for FREE, or included in their salary – of course, why compete with that? (hey, maybe this should be a standard addition to HR directors job descriptions?) I think you'll find existing personnel have their plate fairly full and would rather sub-contract this out.

First: RN's can't prescribe anything except over the counter meds. NP's can and do prescribe anything a Dr can and this is why a supervising Dr+Np set-up is the most efficient combo.

1) Nobody said there was only ONE way to skin a cat. The scenario you described with a caring RN is great and appears to have worked in your example – try to duplicate that across the board elsewhere. What happens with an organization that DOESN'T have mother Theresa RN and wants to implement a program in 4 different plant locations? I'm talking about a “clone-able” system that can be reproduced and implemented where needed.

2) “The program was so well received that the following month, on a Saturday, we did the same thing for dependents” = check your records: dependents are more costly to the plan than the employees themselves! Dependents (not under 14) are encouraged to use the facilities, just as employees.

3) “I read an idealistic scenario. Such a plan is impractical, unrealistic and cost-inefficient. Savings realized from wellness are spent on non-productive bureaucratic structures, administrative/professional fees and costs related to furnishing/supplying the clinics” = WOW, and that was even before I even mentioned how much it cost!!! Sounds like you're already against it before it starts Bill.

4) What is reasonable hourly rate for NP? For MD? For Wellness Program Headquarters personnel? = Physician supervision PLUS Nurse Practitioner time will vary depending on area in USA, but generally anywhere between $60 and $70 per hour for BOTH. Once the initial visits are out of the way and patients are seen routinely, an average NP will see about 3 patients an hour. Make a quick division and tell me if you think this is inefficient and expensive. “Wellness Headquarters” = This will also vary depending on number of program participants, but roughly $1.25 to $2.00 per program participant per month. (you think that's an overbloated price and bureaucracy?)

5) Does consumer make appointment? With whom? The clinic or the Wellness Headquarters? = every organization has their own pet way, but the most usual is an open calendar on the clinic door where anyone can walk by and write their name in an (open) appointment.

6) What happens when consumers (employees/ dependants) overwhelm the clinic and staff? = my first question is: what's the REASON for the overwhelmed appointments? If the visits are episodic and NOT part of a comprehensive chronic risk management program – it's a waste of time (as happens when you don't have any control and just leave it as a “free for all”). Every program participant needs to know that the NP is there to manage chronic risk conditions, not runny noses.

7) “Assembly line care, half-hearted consultation” = Wrong. My experience is that NP's take their job very seriously and like what they do. Because money has been taken out of the equation (they don't get paid fee for service, remember?) they concentrate on their patient care.

8) “hap- Hazard diagnosis, erroneous conclusions and wrong meds? = Sorry, you can pay as much as you like and STILL run the same risk. This is a hazard when dealing with humans – regardless of the money involved. No guarantees either way. Someone NOT liking the advice can always seek care elsewhere.

9) “OR extraordinary waiting time?” = It's important to try and estimate the number of hours needed correctly. Wait time? You're thinking in terms of a doctor's office! Times are very generously set - more so than in a regular Dr's office with many rooms and practitioners in a “patient mill”.

10) Who is monitoring NP - Administrative personnel? Bureaucrat? NP? MD? = There are 2 people monitoring the NP. From a CLINICAL perspective, the supervising Dr. The “bureaucrat” makes sure that the NP has all supplies she/he needs and is addressing chronic risk issues at every visit (minimal runny nose cases). It's important to stay focused and the bureaucrat is there to help keep everything in track from an operational standpoint. You may think management isn't worth the time of day – if so, I assume you're not a manager of any kind.

11) Who is “we”? = me, myself and my organization.

12) How were conclusions “found”? = experience in actual settings.

13) In surveys done for the High Deductible Healthcare Plan (HDHP), statistics show that consumers are more prudent

and selective when spending their own money, then they are when having the blank check of unlimited medical coverage. = to me, this is a laughable conclusion – VERY “insurance-like” and EXACTLY how I used to think when I was in the HMO business! At that time, we were convinced that “abusive patients” were breaking the bank and somehow needed to be pushed away from care in order to save money. We feel ENHANCING access to care – not limiting it – is what's needed to keep chronic conditions in check.

14) In the past, when “little Johnny, or Jeannie” had a sore throat, a “home remedy”, or non-prescription over

the counter medication was given. = Children aren't even eligible to participate in this program – you're mixing apples with oranges. Besides, have you ever heard the word “triage”? There are many ways to “filter” the sore throats to a serious condition by trained personnel that are not Dr's. But in reference to what you're talking about: there are countless 3rd world countries that have this exact scenario happen daily. If you're comfortable with the infant mortality rates, so be it. I'm not and consider this an unacceptable level of care.

15) I would like to hear more details regarding the “cost Free” health care and prescription plans. = I meant employees get a PRESCRIPTION for a particular medication for free, not Free medications. Under most plans now, an employee has to visit a Dr, pay the co-payment, take off time from work and THEN pay for the medication.

16) It is also incumbent on the consumer to take responsibility for his/her actions and judiciously utilize the health benefits provided by the employer. = This is so obvious, I didn't think it had to be mentioned! OF COURSE the employee has to take responsibility! The program allows the company to measure and quantify this. How? By monitoring COMPLIANCE. Without the program, you have no data, no idea what's going on besides an increase in costs.



17) We don't need “…multiple "tricks" to get the whole thing to work“ = I have no idea what “tricks” you are referring to. I'm talking about a professional program that contracts with professionals all along the way.

I hope I've addressed all your points questions, but if not – please write and I'll try to address each one.

Raul

Hello Paladin, Jogeshwar, Rajnish,

I intervene as if the company were to implement an active and ongoing health program focusing on basic, primary, preventive, and necessary aspects for employees, it should be reflected in its other costly health coverage. There may be some individuals who are more inclined to follow this program than others, hence avoiding repetition.

A preliminary and retrospective program is absolutely necessary, especially for heavily loaded and junior companies, with a very cost-effective approach. This is provided they do not believe they have already achieved or surpassed the threshold concerning the health index.

Kind Regards,
umalme

Dear friends,

Namaskar.

Maybe the following excerpt may steer the discussion in the current direction.

Regards,
Jogeshwar

JMIND-BODY INTERACTIONS AND HEALTH: RESEARCH INFRASTRUCTURE PROGRAM (R24)

RELEASE DATE: January 9, 2003

RFA: OB-03-004

Office of Behavioral and Social Sciences Research (OBSSR) (http://obssr.od.nih.gov)

Fogarty International Center (FIC) (http://www.fic.nih.gov/)

National Cancer Institute (NCI) (http://www.nci.nih.gov)

National Center for Complementary and Alternative Medicine (NCCAM) (http://nccam.nih.gov)

National Eye Institute (NEI) (http://www.nei.nih.gov)

National Heart, Lung, and Blood Institute (NHLBI) (http://www.nhlbi.nih.gov)

National Institute of Alcohol Abuse and Alcoholism (NIAAA) (http://www.niaaa.nih.gov)

National Institute of Allergy and Infectious Diseases (NIAID) (http://www.niaid.nih.gov)

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (http://www.niams.nih.gov/)

National Institute of Child Health and Human Development (NICHD) (http://www.nichd.nih.gov)

National Institute of Dental and Craniofacial Research (NIDCR) (link no longer exists - removed)

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (http://www.niddk.nih.gov)

National Institute of Mental Health (NIMH) (http://www.nimh.nih.gov)

National Institute on Aging (NIA) (http://www.nia.nih.gov)

National Institute on Drug Abuse (NIDA) (http://www.nida.nih.gov)

LETTER OF INTENT RECEIPT DATE: June 16, 2003

APPLICATION RECEIPT DATE: July 16, 2003

THIS RFA CONTAINS THE FOLLOWING INFORMATION

- Purpose of this RFA
- Research Objectives
- Mechanism(s) of Support
- Funds Available
- Eligible Institutions
- Individuals Eligible to Become Principal Investigators
- Special Requirements
- Where to Send Inquiries
- Letter of Intent
- Submitting an Application
- Peer Review Process
- Review Criteria
- Receipt and Review Schedule
- Award Criteria
- Required Federal Citations

PURPOSE OF THIS RFA

The National Institutes of Health (NIH), through the participating Institutes, Centers, and Offices listed above, invite applications for infrastructure grants in support of research on mind-body interactions and health. "Mind-body interactions and health" refers to the relationships among cognitions, emotions, personality, social relationships, and health. Applicant institutions may request funds to support infrastructure and research designed to (1) enhance the quality and quantity of mind-body and health research and (2) develop new research capabilities to advance mind-body and health research through innovative approaches. A central goal of this program is to facilitate interdisciplinary collaboration and innovation in mind-body and health research while providing essential and cost-effective core services in support of the development, conduct, and translation into practice of mind-body and health research based in centers or comparable administrative units.

This announcement invites applications for RESEARCH INFRASTRUCTURE PROGRAM R24 grant awards. The companion announcement (RFA-OB-03-005, Mind-Body Interactions and Health: Exploratory/Developmental Research Program) solicits applications for R21 awards, which are intended to support the development and demonstrate the feasibility of programs at institutions that have high potential for advancing mind-body and health research but have not yet fully achieved the necessary resources and mechanisms to qualify for a Research Infrastructure Award.

RESEARCH OBJECTIVES

Background

Please let me know if you need any further assistance.