Atlas of Integrative Health

Transcription

1 Atlas of Integrative Health Health Justice through access to integrative healthcare James Whedon, DC, MS (Atlas Project Director) Colleen Donovan-Batson, CNM, MS Michelle Simon, ND, PhD C. Leslie Smith, MS, MA, LAc, MD, DAMBA Anupama Kizhakkeveettil, BAMS (Ayurveda), MAOM, LAc, CMT, PhD Workshop Advisors: Pamela Snider, ND (Atlas Project Working Group Co-Chair) Nancy Gahles, DC

2 Atlas of Integrative Health Under Development! To be a joint venture of Southern California University of Health Sciences and the Integrative Health Policy Consortium A roadmap: informing policy initiatives that improve access to integrative healthcare for the underserved Mapping Access: current status, temporal trends & state by state variations in: Provider Supply Licensure Scope of practice Utilization Insurance Coverage & Reimbursement

3 Licensed Healing Professions (Five licensed integrative health and medicine professions that have a federally recognized accrediting agency) Chiropractic Naturopathic Medicine Midwifery (Direct Entry/Home Birth) Acupuncture (& traditional East Asian medicine) Massage Therapy

4 Chiropractic Supply of Chiropractors in the US: Uncertain! (Davis et al.: 52,687 in 2004; US Bureau of Labor Statistics: 44,400 in National Board of Chiropractic Examiners: 77,000 in 2013) Regional Variation in Supply of Chiropractors per 100,000 Population Chiropractic Colleges 10,000 students in 18 nationally accredited schools New chiropractors entering the US workforce annually: 2,500 (ACA) Barriers: Limited integration; significant restrictions on insurance coverage

5 Naturopathic Medicine Supply of Naturopathic Doctors in the US: As of 2017 just over 10,000 graduates in the US, over 100,000 NDs globally. 23 States and territories regulate naturopathic medicine. Growing profession: 30% increase in yearly graduates since 2010 (AANMC) Licensure requirements: graduation from one of seven 4 yr residential post graduate naturopathic colleges and passage of doctoral board exam. Regional Variation in Supply of NDs: over 82% of licensed NDs are in the Western states. New NDs entering the US workforce annually: 632 graduates in 2017 (AANMC) Barriers: Incomplete national licensure; variation in scope of practice and insurance coverage. Medicaid: WA, OR, VT. Medicare: not yet included. unregulated regulated Bills filed 2017/18 Bills planned 2018 Bills planned 2019

6 Naturopathic Medicine Supply of Naturopathic Doctors in the US: As of 2017 just over 10,000 graduates in the US, over 100,000 NDs globally. 23 States and territories regulate naturopathic medicine. Growing profession: 30% increase in yearly graduates since 2010 (AANMC) Licensure requirements: graduation from one of seven 4 yr residential post graduate naturopathic colleges and passage of doctoral board exam. Regional Variation in Supply of NDs: over 82% of licensed NDs are in the Western states. New NDs entering the US workforce annually: 632 graduates in 2017 (AANMC) Barriers: Incomplete national licensure; variation in scope of practice and insurance coverage. Medicaid: WA, OR, VT. Medicare: not yet included. unregulated regulated Bills filed 2017/18 Bills planned 2018 Bills planned 2019

7 Acupuncture (LAc, DAOM, etc.) Schools: 57 in the US Most states have licensure No practice act: AL, SD, OK Barriers: Some states restrict autonomy, lack of insurance coverage, competition with other practitioners doing acupuncture MD/DO Variety of training requirements: from no additional training to hours Amer Academy of Medical Acupuncture requires 200 hours of training and 50 hours of CME/3 yrs specifically in acupuncture to maintain membership Board: Amer Bd of Medical Acupuncture DC Variety of training requirements: from no additional training, to hrs, to separate acupuncture license 16 states do not allow chiro acupuncture (without separate licensure) Council of Chiropractic Acupuncture Board: Amer Bd of Chiropractic Acupuncture

8 Massage Therapy # of Practitioners in the US: 300, ,000 Distribution: Concentrated in heavy population areas NY, CA, FL, TX, etc. # of Schools/Programs: New Practitioners entering / yr.: 25,000 30,000 Barriers: 4 States lack licensure, Poor portability state to state, significant restriction of insurance coverage

9 Emerging Healing Professions Ayurvedic Medicine Yoga Therapy Homeopathic Medicine Bioenergetic Medicine Cranio-sacral Therapy & many more both professions & therapies

10 Ayurveda and Yoga Therapy Supply of Ayurveda Practitioners/Yoga therapist in the US: No data available National Ayurvedic Medical Association- Membership driven organization-current practitioners numbers? 938 Professional members International Association of Yoga Therapists- 5,600 from 50 countries Regional Variation in Supply of Ayurvedic practitioners- No data available Ayurvedic and Yoga Colleges NAMA approved Ayurveda schools- 34 Yoga Schools 28 IAYT accredited yoga therapy program Barriers: Information about the practitioners list / Availability of services, Standardization of Education- qualified practitioner Reimbursement - not covered under insurance payment Well defined scope of practice

11 Homeopathic Medicine Practitioners: 35,000 (midwives, ND, MD, DO, DC, RN) Nationwide concentrated in more populated cities LA, SF, NYC, Chicago States: CA, PA, MA, TX, OH, FL Least # of practitioners: Louisiana, Montana, rural areas. Schools: Phoenix, Toronto, Minn, CO, NY, NJ and multiple online programs: nationwide virtual distribution Graduates = ~40/yr and for MD/RN = ~200/yr Barriers to practice: legality, educational accreditation, payment for services (not covered under insurance)

12 Break-out Exercise Divide into small groups - Suggested Questions: 1. What kinds of information would be most helpful for your profession for the Atlas Project to supply? 2. How can the Atlas project best support the growth of your field? 3. What is the status, and what are the challenges for your field with regard to insurance reimbursement? 4. What are the barriers to obtaining accurate data reflective of the supply and location of practitioners in your field? Re-Grouping What have we learned? For more information about the Atlas Project: jameswhedon@scuhs.edu