California Naturopathic Doctors Association 8/7/14 Insurance Inclusion for Naturopathic Doctors ¨ Naturopathic Doctors are seeking credentialing and parity THE BENEFITS OF INCREASING in coverage under California health CONSUMER ACCESS TO insurance programs to NATUROPATHIC DOCTORS improve patient access to high quality primary health care. Including NDs in Insurance Plans Who are Naturopathic Doctors? Makes Sense ¨ Primary care providers (PCPs) ¨ California has a pool of trained PCPs that are significantly ¨ Specialists in the prevention of illness, as well as the underutilized management of chronic disease ¨ NDs offer cost-effective ways of preventing and managing ¨ Trained in both conventional & natural medicine chronic disease ¤ Including NDs in insurance plans has been shown to create savings for ¨ Use conventional diagnostics and standards to payers and insurers, as seen in Washington and Vermont studies diagnose illnesses and health conditions ¨ Until recently, there has not been legislation that directs insurance coverage ¨ Incorporate a variety of natural medicines including for identical services provided by various providers in CA diet and nutrient therapies, counseling, and botanical ¤ Section 2706(a) of the Affordable Care Act, however, does now issue such a directive for all states: "group health plan and a health insurance issuer offering group or medicine into treatment plans individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is ¨ Use prescription medications, scheduled drugs, and acting within the scope of that provider's license or certification under applicable other appropriate therapeutics as necessary state law."
California Naturopathic Doctors Association 8/7/14 California Essential Health Benefits California NDs are licensed to: That NDs are Licensed to Provide • Gynecological services ¨ Diagnose, prevent, and treat disease • Includes STI screenings and prevention counseling ¨ Perform physical exams including orificial exams (oral, vaginal, anal) • Contraceptive methods • Weight loss programs ¨ Order x-rays, electrocardiograms, ultrasounds, CTs and laboratory • Diagnostic tests and imaging tests • Asthma supplies and equipment ¨ Draw blood and perform CLIA-waved laboratory testing in-office • Diabetes equipment, supplies, prescription drugs and education • Cancer screenings ¨ Administer IVs and injections • Vaccinations • Preventative services ¨ Prescribe natural and pharmaceutical medications • Blood pressure, cholesterol, diabetes and obesity screening and ¨ Are eligible for Drug Enforcement Agency (DEA) numbers, giving them prevention counseling the ability to prescribe Schedule III-V drugs • Tobacco and alcohol misuse screening and counseling • Depression screening • Osteoporosis screening • Preventative services for children • Ambulatory patient services Why Should Your Company Contract ND Education With Us? ¨ All NDs attend a four-year graduate level naturopathic medical school ¨ Cost-effectiveness ¤ Both the U.S. Department of Education and the Carnegie Institute classify the ND degree as a First-Professional ¨ A solution to Degree under Doctorate-Professional (Clinical), on par with MD and DO California’s primary ¤ Council of Naturopathic Medical Education (CNME) is a programmatic accrediting agency recognized by the U.S. care shortage Department of Education ¨ Required to pass National Licensing Exam ¨ Consumer demand ¤ Naturopathic Physicians Licensing Examination (NPLEX) ¤ Basic Sciences and Clinical Boards
California Naturopathic Doctors Association 8/7/14 Economic Impact of Chronic Disease in The Burden of Chronic Illnesses California ¨ The four most common causes of chronic disease are Share of Adults with One or More Chronic modifiable health risk behaviors including lack of physical Condition by County, 2002 Total Costs of Chronic Disease activity, poor nutrition, tobacco use, and excessive alcohol in California (2003) consumption ¤ In California, 14 million people (38% of the population) live with at least (Annual Cost in Billions) one chronic condition. Treatment Expenditures: $26.9 ¤ Individuals with multiple chronic conditions – 20% of the population – account for 60% of CA’s healthcare expenditures. 1 Lost Productivity: $106.2 ¨ 90% of health care dollars are spent treating diseases Total Costs: $133.0 that are completely preventable ¨ NDs are the only PCPs trained extensively in counseling, nutrition, exercise prescriptions, and stress management, enabling them to expertly address modifiable risk factors Source: Chronic Disease in California: Facts and Figures. Oakland, CA: California 1 Chronic ¡Disease ¡in ¡California: ¡Facts ¡and ¡Figures. ¡ Oakland, ¡CA: ¡California ¡Healthcare ¡Founda8on, ¡2006 ¡ Healthcare Foundation, 2006. Naturopathic Medicine is Cost-Effective Chronic Illnesses In California Primary Care Medicine ¨ 67.7% of patients in Washington state who Figure 1. Average annual allowed California Health Care Spending by Condition Chronic Illness Incidence in California, 2003 expenditures by CAM use status. Solid receive Naturopathic care do not receive Annual cost per capita, 2002 black: outpatient expenditures from concurrent care from an MD/DO for their 6 16.0% conventional providers; solid white: 15.3% reason for visit (RFV); Naturopathic care is not outpatient expenditures from CAM providers; 14.0% Reported cases in CA (in millions) gray stripe: inpatient expenditures; solid 5 “ add-on ” medical care in most cases . 2 gray: other expenditures not related to a 10.6% 12.0% Percent of Population* provider visit, such as imaging and lab work. ¨ 2001 WA analysis found that Complementary 4 10.0% and Alternative (CAM) services cost ¡ $4,500 � 7.3% approximately $0.20-$0.19 per member per 3 8.0% $4,000 � 5.3 month in HMO and PPO plans. 3 5.4% 6.0% $3,500 � $1,502 � 2 4.5% ¨ After 6 years in insurance coverage of ND PCPs 3.7 $1,164 � 3.3% 4.0% $3,000 � in WA, visits to NDs made up just 1% of all 2.5 1 1.9 outpatient provider visits but accounted for only 1.6 2.0% $2,500 � 1.2 0.7% 0.3% of the dollars paid out by insurers. $765 � $1,178 � 0.2 $2,000 � 0 0.0% Pulmonary Hypertension Mental Heart Diabetes Cancers Stroke ¨ CAM expenditures were dwarfed by the high Conditions Disorders Disease $630 � $1,500 � cost of conventional care (Washington study). 1,2 $1,000 � $1,502 � *As % of non-institutionalized population. Number of $1,219 � Source: Chronic Disease in California: Facts and 1 ¡ Henny, ¡Geoffrey ¡C., ¡Alterna8ve ¡Health ¡Care ¡Consultant, ¡King ¡County ¡Medical ¡Blue ¡Shield ¡(KCMBS), ¡ Phase ¡I ¡Final ¡ treated cases based on patient self-reported data from Figures. Oakland, CA: California Healthcare Report: ¡Alterna;ve ¡Healthcare ¡Project , ¡ 1995. ¡ ¡ $500 � 2003 MEPS. Excludes untreated and undiagnosed cases. 2 ¡ Washington ¡King ¡County ¡Medical ¡Blue ¡Shield ¡Steering ¡CommiKee. ¡ ¡ CAM user � Non-CAM user � Foundation, 2006. 3 ¡ WaKs ¡CA, ¡Lafferty ¡WE, ¡Baden ¡AC. ¡The ¡effect ¡of ¡manda8ng ¡complementary ¡and ¡alterna8ve ¡medicine ¡services ¡on ¡insurance ¡ Reported Cases in California, 2003 benefits ¡in ¡Washington ¡state. ¡J ¡Altern ¡Complement ¡Med. ¡2004; ¡10:1001-‑1008. ¡ ¡
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