Consumers drive integrative medicine popularity in mainstream healthcare system, AHA says

When it comes to complementary and alternative medicine gaining favor in the healthcare industry, the driving force behind the movement is largely the patients themselves, according to a December 14 article published by the American Hospital Association.

Alternative care programs, such as Reiki and tai chi, have gained acceptance in the general public, and a growing number of hospitals are adding such integrative therapies to their menu of services. One main reason is because patients are increasingly requesting these services, and providers are being forced to deliver, the AHA says.

Another reason could be the growing acceptance of nonconventional therapies as an adjunct to traditional medicine. In addition to Reiki, clinicians are incorporating complementary therapies, including acupuncture, yoga, massage therapy, and meditation.

AHA Defines Integrative Healthcare

Alternative medicine: A non-mainstream practice used in place of conventional medicine.

Complementary medicine: A non-mainstream practice used in conjunction with conventional medicine.

Integrative medicine: Conventional and complementary approaches used together in a coordinated way.

How these services are offered varies greatly depending on hospital size, region, and other factors. Some hospitals have comprehensive outpatient integrative medical centers, whereas others offer specific integrative services into inpatient care. Regardless of the service model, providers often run into reimbursement challenges for integrative procedures and programs. Insurers are increasingly covering acupuncture (click here for a recent article on the subject), and some cover massage therapy. But other practices are not covered and, therefore, patients pay for them out of pocket. In some cases, often in the inpatient setting, the services are offered free of charge. Comprehensive outpatient centers operate at a high cost, and some are financed with the help of philanthropy, according to the AHA.

Skepticism of alternative medicine exists, especially in the hospital setting, though the opportunities are endless. Complementary therapies could potentially shorten a patient’s length of stay and reduce need for pain medication. In addition, care experience could be improved.

Ana Drexler, R.N., director of integrative services and palliative care at Portsmouth Regional Hospital in New Hampshire said during an interview with the AHA that creating a “healing environment” is an integral part of quality patient care. For example, Reiki decreases patient’s anxiety and boosts the immune response.

Though Portsmouth hasn’t compared lengths of stay, pain medication use, or patient satisfaction among patients who received complementary therapies and those who did not, surgical patients receiving Reiki were asked to rate their anxiety and pain before and after their procedure in a voluntary survey. Patients almost unanimously reported a decrease in both, says Drexler, who advises hospitals considering implementing complementary techniques to keep its focus on patient care.

The healthcare industry is calling for consumers to have a more active role in their health and wellness, and more and more are growing skeptical of pharmaceutical medications, thanks in part to highly publicized negative side effects. Integrative care providers can combine traditional medicine with complementary therapies, which is an attractive option for patients who are unfamiliar with nontraditional medicine and for providers with an interest in providing it.

Reimbursement Challenges

Most complementary therapies are not covered by insurance. Patients often pay for their care out of pocket and then bill their insurance provider. This tiers off access by income, says the AHA. An estimated 59 million U.S. residents ages four and older had at least one complementary health expense in 2012, according to the National Center for Health Statistics. The average individual out-of-pocket expense was $433 for visits to a complementary practitioner, $368 for natural product supplements, and $257 for self-care approaches. Spending increased with income—the average individual out-of-pocket cost for complementary health approaches was $435 for people with family incomes less than $25,000 and $590 for people with family incomes of $100,000 or more.

Some integrative healthcare professionals are spearheading efforts to make it easier for people to access integrative healthcare options, including the two-hospital Lourdes Health System in Camden, New Jersey. Lourdes has offered complementary services since 1986, and now runs the Lourdes Institute of Wholistic Studies, where people can earn certification in holistic massage, yoga, reflexology, herbal medicine, and aromatherapy.

Lourdes’ mission is to offer therapies patients can’t get elsewhere, says Mark Nessel, the system’s executive vice president and chief operating officer. As is the case with many integrative practitioners, finance is a challenge at the organization, which does not rely on philanthropic funding. Instead, the facility provides services and tries to get reimbursed just enough to cover the associated cost.

The Lourdes facility also addressed financial constraints by partnering with community organizations with a share interest in wellness and complementary therapies, such as the Cherry Hill Health and Racquet Club in New Jersey. The arrangement allows Lourdes, for example, to offer patients access to yoga and tai chi classes without renting space—the organization can have its yoga instructors, who are specially trained in managing chronic conditions and pain, work with patients right at Cherry Hill.

Healthcare is moving from volume-based care to value-based care, and complementary medicine will likely play an increased role in the industry as more and more hospitals adopt integrative modalities of care and incorporate them into existing traditional medical offerings.