resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
January, 2014, Vol. 14, Issue 01
Economic Evaluation of CAM/CIM Practices
By Massage Therapy Foundation Contributor
Contributed by MK Brennan MS, RN, LMBT; Jolie Haun, PhD EdS, LMT, April Neufeld, BS, LMT
In this month's review, the Massage Therapy Foundation's writing group selected a study done in 2012 that evaluates the economy of Complementary and Alternative Medicine (CAM), also referred to as Complementary and Integrative Medicine (CIM).This review is timely given the non-discrimination section of the Affordable Care Act is set to go into effect on January 1, 2014. Section 2706 provides a possibility for insurance reimbursement for massage therapy: "A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable State law."
The objective of the review done by Herman et al., was to establish the value of complementary and integrative therapies within the health reform context. Numerous sources including PubMed, CINAHL, AMED, Psych Info, Web of Science and EMBASE, were searched for information published between 2001 and 2010. The Cochrane complementary and alternative medical group was used for determining the criteria for studies and all of the sources reporting economic outcomes were reviewed with the terms "integrative," "integrated" and "collaborative" medicine added to the search. Three hundred, thirty-eight (338) economic evaluations were identified and 204 of those were published between 2001 and 2010. One hundred, fourteen (114) of the 204 were full economic evaluations with 90% of those being studies of single therapies. Only one study compared usual care to usual care with access to CIM practitioners.
Surveys done in 1990, 1997 and 2007 show estimated out of pocket expenditures of $14 billion, $27 billion and $34 billion for CAM to treat principal medical conditions. This indicates an increase in the use of CAM for healthcare and the willingness of individuals to pay for it. The cost-effectiveness of CAM use, however, has not been well defined. As the authors explain, "Economic evaluations allow costs to be included, alongside data on safety and effectiveness, in healthcare policy decisions. As healthcare costs rise, the availability of these economic evaluations becomes increasingly important to the formulation of disease management strategies which are both clinically effective and financially responsible." This type of evaluation provides massage therapists and other CAM practitioners information that is valuable when meeting with conventional healthcare providers, insurance providers, policy makers, consumers and other stakeholders.
Articles were categorized as full or partial economic reviews. A full evaluation compared the costs, as well as the outcomes, of two or more therapeutic treatments for the same population. A partial evaluation was one that focused on cost-identification or cost-comparison. The authors used the 35-item British Medical Journal checklist to capture components of internal validity and transferability of information. They "also chose five quality criteria by which to identify a subset of full economic evaluations to highlight as being of most interest to policy makers." These include a comparison of CAM to usual and customary care; use of at least one recognized perspective such as hospital or third-party payer; randomized control studies or non-randomized ones that are adjusted to address baseline differences; a measured outcome unless the study was a modeling one that used the data from previously published studies; a sensitivity analysis since assumptions made can factor into uncertainties in economic evaluations.
Items reviewed from the studies that met the above criteria included: "treatment and study duration, primary clinical and economic outcome measures, the setting in which treatment took place, study design and sample size, the type and perspective (i.e., the point of view used to define costs) of the economic analysis, and incremental cost effectiveness of the CIM alternative compared to usual care."
Results of the analysis are mixed. Thirty-one of the full economic studies were considered a higher-quality than the others because they met all five of the study criteria. These indicate potential cost effectiveness and even cost savings across a number of CIM therapies and populations. "Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM therapy versus usual care. Study quality of the cost-utility analyses (CUAs) of CIM was generally comparable to that seen in CUAs across all medicine according to several measures, and the quality of the cost-saving studies was slightly, but not significantly, lower than those showing cost increases (85% vs 88%, p=0.460)."
Other studies reviewed provide information for specific practices and/or settings. For example, cost savings were seen with acupuncture for breech presentations in pregnant women and also for low back pain. Other cost savings were found with some supplements, naturopathic care, Tai Chi and manual therapy.
The methods used in this article are comprehensive and applied multiple measures of study quality in the review of the articles. However, the authors recognize some study limitations, including: 1. The reviewers not blinded to journals and article authors; and 2. Publication bias was not assessed. However, the authors suggest for the purposes of this review, it is not clear if either of these limitations is relevant.
This report and those like it are valuable to those interested in making a case for the inclusion of CAM in healthcare settings or insurance reimbursement as well as consumer awareness. As the use of CAM increases and policies change to increase reimbursement of CAM care, economical evaluations of this type are needed to determine the use and cost effectiveness of CAM in the healthcare setting.
To learn more about the economic impact of CAM, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search Pub Med for CAM/CIM cost analysis studies.
Click here for more information about Massage Therapy Foundation Contributor.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.