by John Weeks, Publisher Editor of The Integrator Blog News & Reports Aetna CEO Bertolini goes to bat for yoga, acupuncture naturopathic doctors, yoga and other integrative practicesAccording to this post following a keynote at the conference of the New York Association

by John Weeks, Publisher/Editor of The Integrator Blog News & Reports 

Aetna CEO Bertolini goes to bat for yoga, acupuncture naturopathic doctors, yoga and other integrative practices

According to this post following a keynote at the conference of the New York Association of Naturopathic Physicians, Mark Bertolini, CEO of the Aetna insurance giant, has become a huge advocate for naturopathic doctors, acupuncture and other integrative methods. Bertolini transitioned from believing it all “voodoo medicine” following a serious accident he had while skiing, for which he explored “cranial sacral therapy, acupuncture by a medical physician, naturopathy and yoga – and all of that has created a cocktail for me that allows me to live in a relatively pain-free world without any drugs.” The Revive Naturopathy site suggests Bertolini is involved in federal efforts to promote the naturopathic profession. Bertolini’s views are
clear in this March 19, 2013 CNBC video at 3:43 of the 8-minute segment, following a question from Arianna Huffington. He also speaks to Aetna’s cost savings from a yoga and mindfulness program (11 to 1 return on investment, or $3000 per year per employee) then to his personal journey toward health. 

Comment: Bertolini’s interview is fascinating. The take home suggests that a true paradigm shift might happen not, as is sometimes suggested, when the old finally die. Rather, reform might begin if a few score other insurance executives tumble over 30 foot cliffs, as Bertolini did, then find their way to health and productivity via constructing their own teams of integrative health practitioners. His story of a fall that transitioned him from declaring all non-conventional treatment voodoo to exalting it ranks with Alice’s shock on taking her tumble. 

Chiropractic policy leader Gerry Clum, DC lays out perspectives on chiropractic under the Affordable Care Act

A quality interview of the director of the Octagon Institute at Life University, Gerry Clum, DC in Health Insights Today (and reprinted here in Dynamic Chiropractic) captures key aspects of the way the Affordable Care Act may influence the
future of chiropractic payment – and what individual chiropractors can do. On the subject of the new focus on quality of care and outcomes, Clum states: “The idea that we can continue to see patients for X number of visits over Y period of time – without periodic evaluations that show progress in their functional improvement – is long gone. Probably the biggest change for chiropractors is that we need to start thinking about what we can do to demonstrate that between point A and point B, Mrs. Smith has improved. And the fact that I find greater joint mobility at her C6 and C7 is nice, but it doesn’t answer the question.” He adds: “We’ve got low back indices, neck indices, indices for everything under the sun. Their use is going to have to become routine.”

Clum speaks to the chiropractor’s role in the evolution of Accountable Care Organizations and Patient Centered Medical Homes. He begins by prescribes reading: “The first thing I would [urge] is start Googling ‘accountable care organizations,’ and spend half an hour wandering through websites and reading until you get a sense of what they are.” He concludes that these entities represent “a free-market arrangement,” adding: “Chiropractors can function anyplace they can inject themselves into the system. In this scenario, it is crucial that chiropractors understand the literature regarding cost-effectiveness and patient satisfaction associated with the care that we deliver.”

Comment: Clum, a colleague in a project of the Academic Consortium for Complementary and Alternative Health Care entitled Project for Integrative Health and the Triple Aim, is a clear, even thinker on these topics. His counsel in this piece is excellent.     

Major Hawaii insurer opens to naturopathic doctors and  other licensed “CAM” practitioners

An October 8, 2013 note to naturopathic physicians in Hawaii from Michael Traub, ND, DHANP, long-time integrative medicine leader on the island of Hawaii, shares news from a Senior Business Analyst for Provider Relations for the island’s major insurer, the Blues plan HMSA: “HMSA’s legal department has determined that naturopathic medicine must be a covered benefit in HMSA’s plans effective Jan. 1, 2014, as provided in the Affordable Care Act, Section 2706 (pertaining to non-discrimination).  He adds that the insurer “will be hosting a webinar for NDs and ‘other specialties’.” Traub assumes this may include chiropractors, acupuncturists, certified midwives and massage therapists.” 

Due to HMSA’s “missed deadline, in 2014 patients with HMSA coverage will pay up front for their naturopathic care, and then submit a claim to HMSA to be reimbursed.”  NDs can be “participating providers” in 2015. Reimbursement rates were not revealed. Writes Traub: “It will be better than nothing.” He also notes that the coverage will “allow NDs to order lab work and imaging studies for patients, and when the lab or imaging center bills HMSA, the claim will be paid based on how the benefits are defined in the particular HMSA plan.” Traub notes that he plans to contact the state’s other leading insurers, including Kaiser, on “their compliance” with Section 2706 “Non -Discrimination in Health Care.” Traub copied the Integrator on his note and approved publication.

Comment
: Nice to see an insurer respecting the intent of Section 2706. One wonders what guidance HMSA may have received from Blue Cross Blue Shield’s national office. If they payment levels are respectful, HMSA – by far the dominant insurer in the state – should be promoted as a benchmark plan. Traub is as experienced as anyone, nationwide, in these environments. The past president of the American Association of Naturopathic Physicians can count among his credits leadership of the integrative medicine effort at the pioneering North Hawaii Community Hospital. Be nice to clone him and send him out into the 50 states. 

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