healingways


value coverage that includes annual wellness exams, phone or virtual appointments and educational classes, plus follow- ups and urgent care at minimal costs. The U.S. mainstream fee-for-service approach, whether


paid by insurance or cash, has been criticized for encouraging unnecessary tests and procedures because doctors are paid for services performed. To maintain income, they typically shorten appointments to increase the number of patients they see. Lewis emphasizes, “Time is the valuable factor in


DPC—healthy lifestyle changes, which can prevent or re- verse 70 percent of health concerns, cannot be communi- cated in 10 minutes.”


Medical Cost-Sharing For generations, Christian communities have oper- ated health care sharing ministries (HCSM) to col- lectively share the cost of each other’s medical bills as


AFFORDABLE Complementary Care


Alternatives to Insurance Cost Less by Meredith Montgomery


T


he latest National Health Interview Survey available, from 2012, shows an annual expenditure of $30.2 billion in out-of-pocket costs for complementary health


approaches, benefiting 33 percent of adults and 12 percent of children, and representing about 10 percent of out-of-pocket U.S. healthcare costs. Insurance rarely covers complementary and alternative medicine (CAM) in full. As provider networks shrink, premiums rise and the future of healthcare reform remains uncertain, health-conscious consumers yearn for innovative ways to afford this kind of care.


Membership-Based Care When Dr. Chad Krisel worked at an urgent care center, he saw up to 55 patients a day. Since opening Integrative Fam- ily Medicine of Asheville (IntegrativeAsheville.org), in North Carolina, with Dr. Brian Lewis, he averages 12 patients a day. His team provides a membership-based practice in a payment model known as direct primary care (DPC). Endorsed by the American Academy of Family Physi- cians, DPC is broadly accessible. By applying simplicity, sustainability, quality and collaboration, their integrative practice provides comprehensive care for less than what many pay for phone service. “DPC removes traditional financial incentives and conflicts of interest because mem- bership fees fund us. Our only incentive is to help and heal patients,” Krisel explains. Paying for memberships out-of-pocket (often electing high-deductible plans) or via a health-sharing plan, clients


28 Long Island Edition


an alternative to outside insurance. Members are exempt from current Affordable Healthcare Act (ACA) mandates. Liberty HealthShare, a nonprofit HCSM chartered by the Mennonite church, believes that everyone has the right to practice religion as they see fit. Their members share a commitment to personal health and sharing in the burden of health expenses with others that have these values. “Many in the functional and integrative medical arenas also believe in these principles,” says Tom Blue, of Richmond,


Virginia, a director with The Institute for Functional Medicine. “Cost sharing feels very familiar; you present your card to your provider, but there’s no set network of providers, which is favorable for those seeking more progressive forms of care.” Expanding upon this model, Blue worked with the com-


pany to create its Liberty Direct program (LibertyDirect.org). Individuals pay an annual membership fee plus a monthly share amount. After fulfilling their annual unshared amount of out-of-pocket expenses (similar to a deductible), partici- pants’ healthcare costs—including approved naturopathic and alternative treatments—can be submitted as expenses to be shared by the group. Liberty Direct provides financial advantages to DPC


practitioners and patients by subsidizing membership fees; it favors nutrition over chronic prescription dependence by reimbursing physician-prescribed nutritional supplement and pharmaceutical expenses under the same terms. Members must be in good health with a lifestyle that helps sustain wellness, including good nutrition, exercise and abstinence from tobacco use and drug and alcohol abuse. The program also accepts approximately 7 percent of applicants on provisional terms when pre-existing conditions such as hypertension, obesity and diabetes can be improved through lifestyle changes. They pay an extra fee per month to cover the cost of a health coach; when they achieve their goals, they become full members paying regular rates. “The economics are staggering,” says Blue, who used to


pay $760 a month for insurance with a $12,400 deductible and now pays a monthly share of $449 with a family unshared amount of $1,500. HCSMs are affordable because of restricted


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