The dietary behavior research firm Viocare makes an online tool that enables health care providers like the Mayo Clinic to gather 90 days of dietary data from a patient in just 30 minutes — then use this knowledge to help the patient adopt a healthier lifestyle.
Now President Rick Weiss is leading the Princeton company toward a new frontier: getting insurers to reimburse health care providers that use Viocare's dietary behavior tools.
The Mayo Clinic uses the product, called "VioScreen," to identify patients that might benefit from counseling by a registered dietician. "But the Mayo Clinic has to eat that cost — they don't get reimbursed for using my technology," Weiss said.
That could soon change. A transformation slowly under way within the health care system, pushed along by the federal Affordable Care Act, is creating more opportunities for Viocare to expand the commercial market for its research. Insurers and other payers, such as self-insured corporate health plans, are exploring "bundled" payment systems, in which hospitals and doctors get a lump sum to manage a diabetic or congestive heart failure patient, rather than being paid for every test and procedure they perform.
In this new payment model, Viocare would be compensated for working as part of the clinical team that gets a patient's chronic disease under control
"I think my business is finally in the right place at the right time," Weiss said.
Since Weiss founded the company 20 years ago, Viocare has received 23 research grants, totaling about $11 million, from the National Institutes of Health and other research partners. Weiss said the company figured out early on that "the problem of dietary behavior is a necessary part of the clinical environment — but the health care system was not ready for it."
But he said payers are now reaching the point of saying: "I'm going to pay you, Dr. Smith, to manage this patient's diabetes, and you're going to get a fixed dollar amount, and whatever you save, we'll share it." In this new, holistic care environment, "our capabilities will become more and more important," Weiss said.
Peter Gillies, director of the New Jersey Institute for Food, Nutrition and Health at Rutgers University, said, "Physicians don't get a lot of nutrition education as part of their medical training, so tools that put credible and current information in their hands is a step in the right direction." Gillies wants the medical establishment to travel further down this road, and "integrate modern-day molecular nutrition, e.g., nutritional genomics, into the medical curriculum so that nutritional pharmacology is as valuable and important to doctors as medical pharmacology."
Weiss said Viocare is building upon health care's migration to the patient-centered medical home, in which teams of doctors and other clinicians work together to improve the health of the entire population of patients in the practice. He sees this model expanding out from "home" to "neighborhood" to address the behavioral aspects of health. Viocare's latest research project with the National Heart, Lung and Blood Institute illustrates the neighborhood concept. The study involves a large practice of 77 family care physicians at Ohio State University, and registered dieticians at Giant Eagle supermarkets.
"Most physicians don't have the time, the knowledge or the capability to address dietary behavior change," Weiss said. The doctors will use Viocare's tools to identify patients that need dietary counseling, refer them to a registered dietician at the supermarket and coordinate their care.
Weiss said in the Ohio study, the dietician will be take patients through the supermarket to personalize their diets, and the dietician's work becomes part of the patient's electronic health record.
Jeff Brown, chief of staff for the New Jersey Health Care Quality Institute, said Viocare appears "to be on the forefront of where a lot of health care is going in terms of wellness and data collection. The interesting thing is that they are not just offering wellness products, they are offering data collection and analysis product for consumers." He said data "is going to be key as we move into the next era of health care, and translate that data into meaningful measurements of health and wellness."
Weiss said going forward, Viocare's research will to focus on tools that address dietary behavior. This fall in Philadelphia, the company will test a new mobile app called "VioDine," developed with a National Cancer Institute grant. Using the GPS on a mobile phone, VioDine finds the best menu item for you at a nearby restaurant, based on your dietary needs. Weiss said "You go to Yelp to find a restaurant; we will help you find the specific menu item you need."
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