About Advancing Integrative Health

September 5, 2017

Integrative Health and Medicine in the U.S. Mid-2017

This map is a high-level view of the presence of integrative healthcare in the US today: at US medical schools operating centers of integrative medicine, or CIMs (the AHCs); large private systems, such as Mayo and Cleveland clinics; Allina in Minnesota; Medstar and Inova in the mid-Atlantic (HS); and scores of thousands of independent integrative clinics across the country.

Driven almost entirely by patient and consumer preferences since the mid-1980’s, therapeutic techniques and approaches such as acupuncture, massage therapy, chiropractic and naturopathic medicine have found a place in U.S. healthcare system.  But this availability remains uneven, constrained, and unaffordable where services are not reimbursed by insurance: which is almost everywhere.  This presents a major disconnect, particularly for beneficiaries of Medicare and Medicaid who suffer complex and costly conditions for which integrative care approaches have proven particularly well suited.

(Of Interest:  a new Definition of Integrative Health that describes its important influences on the future of treatment and care, as it is being delivered across the map above.)


THE WORK

We work independently and with organizations working to advance integrative health by focusing on  policy, clinical services, patient access and financing issues, primarily by addressing the interwoven necessities of Expanding Access and Raising Awareness.

RAISING AWARENESS

For Major Policy and Program Leaders:
The Integrative Healthcare Briefing

Although the advances in availability of integrative care are well appreciated within some segments of the healthcare system, we found that many influential national policy organizations retain an outmoded and incomplete view of the efficacy, evidence base and positive outcomes of   integrative care.  As a result in 2017, we developed the Integrative Healthcare Briefing – The IHC Briefing — to provide these organizations with a current understanding of the growth of integrative health and medicine (also functional and lifestyle medicine) in the U.S. and how it is responsive to national health  policy objectives.  The map above is part of it.

The objectives of the briefing and follow-on conversations:
Generate or gain support for near-term actions where possible —  most notably in 2017 as options to confront the opioid addiction epidemic — where non-pharmacologic integrative options provide a clear therapeutic advantage.
Align policy and program messaging and language with the real-world presence of integrative care in the marketplace.
Foster a conversation between the Integrative Community and CMS

(First presentations in June 2017 to:
• The Deputy Administrator of CMS for Innovation (CMMI) and colleagues
• Senior legislative and programs managers at AARP)

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EXPANDING ACCESS & RAISING AWARENESS

Ending Insurer Discrimination Against State-licensed Providers
CoverMyCare

The CoverMyCare project is a good example of how access and awareness issues around integrative health are intertwined.  The “access” was defined in Federal Law in Section 2706 of the Affordable Care Act.  Its provisions prohibit private health insurance plans from excluding licensed healthcare providers – of any discipline – from their networks.

But like many statutes, this one had designed into it a large escape clause that essentially permitted the insurers to avoid compliance. Directions from state insurance regulators – the guarantors of compliance – have not been forthcoming due to ambiguous direction from the US Dept. of Health and Human Services.  With a handful of instances of compliance in 3+ years, there is still more to do.

Conceived for and implemented and managed with the Integrative Health Policy Consortium (IHPC), CMC was the first initiative from a major integrative policy group that was designed to engage grass roots non-discrimination and patient rights advocates.  The project has tracked and supported non-discrimination advocates in the states, where change is ongoing.

 

RAISING AWARENESS

Origins: “The Rise of Integrative Health and Medicine
The Milestones: 1963 – Present”

Along the rocky timeline of this rise you will find:
• The US Air Force installed an acupuncture clinic at Join Base Andrews in 2011.
• Mindfulness (i.e., meditation) was first treated as a health-creating method in 1971.
• Cancer Treatment Centers of America began applying integrative therapies for cancer patients in 2010.
• U.S. Sen. Tom Harkin of Iowa compelled NIH to start research in the early 1990s, after studies showed millions of Americans used “holistic” therapies.
• Among the 125 events, policy changes, organizational developments and other actions along the Timeline that have established the viability of modern integrative, whole-health care.

Despite the fact the the public has been pushing for access to holistic options since the 1970s, the innovators who were outside of conventional medicine, later joined by MDs in the mid-1990s, created an arduous, often thankless experience that took vision, courage, and ingenuity.  Along the way they created the first forms of real “patient-centered” care.

IHS principal Taylor Walsh was co-author on this e-book with its publisher, Glenn Sabin (FON Consulting).  Recounting what recorded the inevitable rise of integrative care in American healthcare was built almost entirely on the work of our colleague and the original historian of the integrative movement, colleague John Weeks.   See more about the project here.

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