IHPC Highlights Top Policy Priorities

In its recent annual retreat and board meeting, the Integrative Health Policy Consortium (IHPC) identified its top five policy priorities for 2023, based on survey responses from its Partners for Health:

• Enhanced coverage of integrative health services
• Pain management
• Expanded access to integrative health services
• Training
• Research

During the meeting, member organization expanded on their survey answers, and voiced concerns about insurance coverage, public relations, and credential recognition. We’ve rounded up the most pertinent takeaways for integrative healthcare professionals.

Enhancing Insurance Coverage

Amy Mack, CEO of the Institute for Functional Medicine said use of insurance by practitioners in private practices is limited, with many practices operating in the fee-or-service model. However, a growing number of practitioners are practicing aspects of functional medicine in institutions where insurance is utilized. A recent National Academies of Science, Engineering, and Medicine report on the United States Department of Veteran Affairs (VA) Whole Health program supports involvement of functional, integrative, and naturopathic medicine alongside conventional medicine for veterans and active military personnel. IFM, she said, is currently working with the VA in a pilot study in New Jersey integrating functional medicine with the Whole Health program to address type 2 diabetes.

A lack of insurance reimbursements is also a concern among recent graduates of Southern California University of Health Sciences (SCUHS) practicing Ayurvedic medicine, acupuncture, and Traditional Chinese Medicine (TCM), and chiropractic medicine. According to Robb Russell, DC, assistant vice president and clinical chief of staff at SCUHS, Ayurvedic practitioners receive no insurance reimbursement, while acupuncture and chiropractic practitioners have limited reimbursement or access through most types of insurance.

Addressing Pain Management

Russell also highlighted a new bill, AB 1751, sponsored by the California Chiropractic Association, which would require physicians to share information on the negative impacts of opioid medication, and discuss or recommend non-pharmacologic approaches like chiropractic, acupuncture, yoga, and massage to their patients when they sign an informed consent. The bill is being actively opposed by the California Medical Association, which suggested in a press release that the bill would place “unnecessary burdens on physicians trying to prescribe pain management.”  

Beth Clay, executive director of the International Chiropractors Association (ICA), suggested that chiropractors and their role in medicine are often overlooked in policy. She stated that chiropractors should be included in more of the legislation related to pain management and the opioid crisis, as well as being included in the recently published United States Department of Health and Human Resources (HHS) National Cancer Plan.

Expanding Access to Integrative Health Services

For organizations like the American Society of Acupuncturists (ASA), another factor limiting medical coverage of their services are the wide variations of scope of practice from one state to another. According to Nell Smircina, DAOM, LAc, director of development for the ASA, these variations complicate Medicare coverage for acupuncture.

According to Smircina, acupuncture is covered by Medicare for chronic low back pain, but to be reimbursed, the acupuncturist must have a medical doctor (MD) “supervisor.” However, more than 90 percent of acupuncturists in the U.S. are in private practice with no relationship to a physician she said. Smircina said Congress could simply amend title XVII of the Social Security Act to include acupuncturists as providers under Medicare. This amendment was part of the bill, HR 4803, the Acupuncture for Our Seniors Act of 2021, but as of now, more bipartisan support is needed for it to pass.

Improving Education and Training

Margaret Erickson, PhD, RN, CNS, APRN, APHN-BC, SGAHN, CEO of the American Holistic Nurses Credentialing Corporation (AHNCC), also cited varying scopes of practice in states as a major challenge to the holistic nurse community. Holistic nurses, she said, are unique in the corporate healthcare system. Their focus on the patient and the mind-body-spirit connection adds value to the field of nursing, which generally focuses on treating the patient’s immediate disease or illness. Erikson said there is need for more recognition of holistic nursing in the policy space for education and training, reimbursement, and research grants.

Increasing Research

Certified Nutrition Specialists (CNS) also need more recognition in education, insurance, and research, according to Judy Stone, MS, MSW, a functional nutritionist at the Center for Functional Nutrition. Though the CNS credential is more than 30 years old, with a lack of research grants to further establish the field, Stone said CNSs are still considered “new” in terms of healthcare policy, especially on the federal level.

"IHPC and its Partners for Health have a comprehensive understanding and perspective on patient-centered integrative health, specifically removing barriers between providers and patients,” said John Wyble, Executive Director of IHPC. “By establishing strategic priorities around critical public policy reforms, we send a clear message to Congress and stakeholders on behalf of 650,000 providers to rethink patient health, healing, and recovery."