TY - JOUR
AU - K. E. McKee
AU - M. R. Rafferty
AU - T. W. Sakata
AU - D. M. Hedges
AU - G. J. Griffith
AU - M. M. K. Bingham
AU - S. A. Obradovich
AU - M. N. Francis
AU - D. M. Corcos
A1 - 
AB - As Parkinson's disease (PD) progresses, relatively mild symptoms advance to a major disorder that affects every organ system in the body. Current care for people with PD (PwP) reacts to rising disability. There is a missed opportunity to keep PwP as healthy as possible. In this perspective, we spell out our vision for a proactive, value-based health care model built around a patient-centered integrated practice unit (IPU) for PD. The IPU will provide integrated interdisciplinary care overseen by a specialized Parkinson's primary care physician working closely with a movement disorders neurologist. The IPU will implement an evidence-based exercise program for people early in the disease. The focus of this intervention is a heart rate driven high-intensity aerobic exercise program, which is the only treatment with evidence that it can slow disease progression. It will also include resistance exercises, flexibility exercise and balance exercise. For people whose disease is moderate or severe, the IPU will provide care curated through a network of rehabilitation providers with expertise in PD all of whom understand the exercise prescription. By integrating care, slowing disease progression, and incorporating specialized rehabilitation we anticipate improving healthspan. In creating the IPU as a fully capitated (shared-risk) model in which the IPU and the insurance company assume joint accountability for quality and cost of care we anticipate demonstrating financial sustainability of implementing the exercise prescription and providing integrated care.
AD - Department of Neurology, Intermountain Medical Center Neurosciences Institute, Intermountain Health, Salt Lake City, UT, United States.; Shirley Ryan AbilityLab, Chicago, IL, United States.; Department Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, United States.; Department of Family Medicine, Intermountain Health, Salt Lake City, UT, United States.; Healthcare Delivery Institute, Intermountain Health, Salt Lake City, UT, United States.; Department of Analytics, Select Health, Salt Lake City, UT, United States.; Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States.; Neurologic Physical Therapy, Intermountain Park City Hospital, Park City, UT, United States.; Lifestyle Medicine and Wellness Center, Intermountain Park City Hospital, Park City, UT, United States.
AN - 40529404
BT - Front Sports Act Living
C5 - Medically Unexplained Symptoms
DO - 10.3389/fspor.2025.1529075
DP - NLM
ET - 20250602
JF - Front Sports Act Living
LA - eng
N2 - As Parkinson's disease (PD) progresses, relatively mild symptoms advance to a major disorder that affects every organ system in the body. Current care for people with PD (PwP) reacts to rising disability. There is a missed opportunity to keep PwP as healthy as possible. In this perspective, we spell out our vision for a proactive, value-based health care model built around a patient-centered integrated practice unit (IPU) for PD. The IPU will provide integrated interdisciplinary care overseen by a specialized Parkinson's primary care physician working closely with a movement disorders neurologist. The IPU will implement an evidence-based exercise program for people early in the disease. The focus of this intervention is a heart rate driven high-intensity aerobic exercise program, which is the only treatment with evidence that it can slow disease progression. It will also include resistance exercises, flexibility exercise and balance exercise. For people whose disease is moderate or severe, the IPU will provide care curated through a network of rehabilitation providers with expertise in PD all of whom understand the exercise prescription. By integrating care, slowing disease progression, and incorporating specialized rehabilitation we anticipate improving healthspan. In creating the IPU as a fully capitated (shared-risk) model in which the IPU and the insurance company assume joint accountability for quality and cost of care we anticipate demonstrating financial sustainability of implementing the exercise prescription and providing integrated care.
PY - 2025
SN - 2624-9367
SP - 1529075
ST - Parkinson's Elevated: improving healthspan
T1 - Parkinson's Elevated: improving healthspan
T2 - Front Sports Act Living
TI - Parkinson's Elevated: improving healthspan
U1 - Medically Unexplained Symptoms
U3 - 10.3389/fspor.2025.1529075
VL - 7
VO - 2624-9367
Y1 - 2025
ER -