What is integrative medicine?

Studies indicate that United States citizens are, on average, not as healthy as those from other wealthy countries.¹ Because of this, many Americans seek comprehensive medical care.

While conventional medicine may be a suitable treatment option in some cases, Americans with chronic medical conditions may turn to alternative and natural medicine to help treat them, leading to integrative medicine practices becoming more popular² over the past decade.

According to the National Center for Complementary and Integrative Health (NCCIH), roughly 38% of U.S. adults³ receive some form of integrative medicine. More healthcare practitioners are studying integrative medicine therapies to meet this demand so patients can access care more quickly. But what is integrative healthcare, and how can it benefit consumers?

This article will walk you through the ins and outs of integrative medicine and explain how employers can cover their employees’ out-of-pocket expenses for holistic treatments.

What is integrative medicine?

Integrative medicine is a type of holistic medical practice that focuses on a person’s physical, mental, and spiritual needs to achieve optimal health. Integrative medicine practitioners often form close relationships with their patients. They use evidence-based therapies and lifestyle changes to provide personalized and appropriate care plans based on the individual’s whole body and health history—not just treating one particular symptom or illness.

Integrative medicine stimulates health and wellness by combining the following two types of medical practices:

1. Conventional medicine: Also known as traditional Western medicine, this practice involves treating symptoms and diseases with prescription drugs, surgeries, and other standard treatments.
2. Complementary medicine: This practice combines alternative health services and treatments that may help improve a person’s well-being and ease symptoms that affect their quality of life.

In contrast to alternative medicine, which individuals access instead of conventional medicine, integrated medicine coordinates care among different physicians, practitioners, and providers—whether the care is traditional or not. Integrative approaches treat acute and chronic conditions and provide a broad range of medical care to keep an individual healthy long-term.

What are common integrative medicine practices?

Receiving only conventional medical care, like surgery and prescription drugs, may work for some individuals. But others may be adverse to certain treatments or experience side effects from specific medications.

Integrative medicine provides more natural treatments that promote the health and healing process through prevention and healthy living, filling in the gaps that conventional medicine may not fill. This can lead to fewer prescriptions, doctor visits, chronic conditions, and emergency medical care.

The following are examples of common integrative medicine practices and services:

• Acupuncture
• Chinese medicine and herbal therapy
• Chiropractic care
• Culinary medicine
• Psychotherapy and hypnotherapy
• Massage therapy
• Yoga, tai chi, and Reiki healing
• Animal-assisted therapy
• Aromatherapy and homeopathy
• Meditation and mindfulness
• Music and art therapy
• Resilience training
• Functional medicine

Integrative medicine providers vary depending on the service, but they can include conventional physicians, nurse practitioners, naturopaths, chiropractic doctors, mental health professionals, massage therapists, and more. These practitioners only provide thoroughly researched, safe, and appropriate therapies for a person’s health status or condition.

Who is best suited to receive integrated medicine?

Anyone can benefit from an integrated treatment plan to improve their physical, mental, and spiritual well-being. However, individuals with chronic or complex health conditions may find it especially advantageous.

The National Poll on Healthy Aging⁴ found that 91% of older adults found integrative approaches beneficial for managing ongoing conditions like diabetes, high blood pressure, obesity, or a mental health condition. If you have an older workforce, your employees may find that coupling conventional and complementary care helps them achieve better results.

A few conditions that integrative medicine can provide relief for include the following:

• Autoimmune diseases
• Acute and chronic pain
• Sleep disorders and chronic fatigue
• Headaches and migraines.
• Cancer and cancer-related illnesses
• Digestive disorders
• Infertility, menstrual, and menopausal symptoms
• Mental health conditions, including anxiety and depression
• Obesity and diabetes
• Heart disease and high blood pressure
• Chronic conditions like arthritis, fibromyalgia, and multiple sclerosis
• PTSD

Remember that integrative medicine physicians don’t replace a primary care physician or specialist for a specific condition. These practices should complement conventional treatments, and holistic providers should coordinate their treatments with the individual’s other physicians to provide the best overall care and avoid confusion, misdiagnosis, or overmedication.

What health benefits provide coverage for integrative medicine?

Most traditional health insurance policies cover all or some of the cost of conventional medical services. The Affordable Care Act (ACA) also requires all plans sold on public and private exchanges to cover essential health benefits. However, insurers don’t often cover integrative healthcare, meaning patients can be stuck paying for their services out-of-pocket.

According to the NCCIH⁵, Americans pay $30.2 billion annually on complementary and integrative medicine practices, comprising 9.2% of all out-of-pocket medical spending in the country. Some insurance companies cover a few complementary treatments, like acupuncture and chiropractic care. But even so, there’s limited coverage, and plans often exclude many other therapies, leaving patients with a surprise medical bill.

If you’re an employer, you can offer your employees alternative health benefits to help them pay for their out-of-pocket costs if they want integrative medical care. Let’s go over a few of your options in the sections below.

Health reimbursement arrangements (HRAs)

A health reimbursement arrangement (HRA) is an employer-contributed health benefit allowing employers to reimburse their employees tax-free for more than 200 qualified out-of-pocket medical expenses, including individual health insurance premiums. With an HRA, employers choose how much monthly allowance to offer their employees. Once an employee submits proof of an eligible expense, the employer reimburses them up to their set allowance amount.

Employers often offer an HRA instead of a traditional group health plan to save on rising medical costs and give their employees greater control over their healthcare outcomes.

Here are three of the HRAs that PeopleKeep offers:

1. Qualified small employer HRA (QSEHRA): A QSEHRA is for small employers with fewer than 50 full-time equivalent employees (FTEs). With a QSHERA, employees can receive reimbursements for their individual health plan premiums and qualified out-of-pocket expenses. However, QSEHRAs have annual maximum contribution limits set by the IRS.
2. Individual coverage HRA (ICHRA): An ICHRA is for employers of all sizes that can reimburse employees for their individual health insurance premiums and other out-of-pocket expenses. It has no maximum contribution limits and allows employers to set different monthly allowances by specific employee classes.
3. Group coverage HRA (GCHRA): A GCHRA, also known as an integrated HRA, supplements an employer-sponsored group health plan. Employees can use their allowance to pay for out-of-pocket medical costs their group plan doesn't fully cover, like deductibles and copays. Like ICHRAs, GCHRAs have no maximum contribution limits, and employers can set different allowances based on employee classes.

Employees can receive reimbursement for all items outlined in IRS Publication 502. Most traditional services and items are reimbursable with just a receipt or invoice, like physical therapy, mental health counseling, and other conventional therapies. However, integrative medical costs are only reimbursable with an HRA if an employee provides a doctor’s note explaining that the services or items are medically necessary.

Some eligible integrative medicine services and items that are reimbursable with an HRA if you have a doctor’s note include:

• Alternative healers
• Alternative dietary supplements
• Dermatology products
• Dietary supplements
• Dietitian/nutrition services
• Herbal or homeopathic medicines
• Magnetic and massage therapy
• Nutrition supplements, vitamins, and special foods

An HRA is a great way to cover conventional and integrative healthcare without breaking your company’s benefit budget. By offering this flexible health benefit, you’ll be sure to meet every employee’s needs and stand out as an employer of choice.

Health stipends

Another option you can offer is a health stipend. In general, a stipend is a fixed amount of money that employers typically add to their employees’ paychecks to pay for a wide range of expenses, whether on a one-time, recurring, or reimbursement basis. Specifically, a health stipend helps employees pay for their health insurance plan premiums and other out-of-pocket medical costs. There are no minimum or maximum contribution limits with employee stipends.

Because health stipends aren’t considered a formal health benefit, they don’t come with as many regulations as traditional health insurance or HRAs and offer employees more freedom to use their allowances to pay for their chosen medical care—like complementary and integrative medicine. However, you can’t require employees to submit proof that they spent their stipend on any items in IRS Publication 502.

A health stipend can cover integrated medical expenses such as:

• Herbal and nutrition supplements
• Doctor's appointment costs to receive complementary or integrative healthcare
• Probiotics
• Botanical medicine
• Mental health counseling
• Traditional Chinese medicine
• Clinical trials
• Complementary therapies, such as acupuncture and chiropractic care

Because stipends are a taxable benefit, there’s no limit to how you can design them, so encourage your employees to use their stipend money to pay for the healthcare expenses that matter most to them.

Wellness stipends

Lastly, a wellness stipend allows you to provide a monthly allowance to your employees for their wellness costs. While health stipends generally cover insurance premiums and other medical expenses, wellness stipends can cover any costs related to promoting a healthy lifestyle and supporting your employees’ holistic well-being.

Some examples of expenses that a wellness stipend can help cover are:

• Wellness mobile apps, such as those for meditation or mindfulness
• Gym memberships
• Yoga classes
• Wearable fitness devices
• Home exercise equipment
• Alternative therapies, like aromatherapy and music therapy
• Any other wellness-related expenses you choose to allow for reimbursement, including integrative medicine services

With a wellness stipend, you can give your employees the chance to improve their health outcomes using whatever method they prefer to receive care. They can live healthier, manage chronic diseases, and better support their overall wellness.

Conclusion

An increasing number of Americans want the medical industry to not only treat illnesses with traditional methods but also incorporate integrative medicine that blends conventional and complementary practices to create a more personalized approach to healthcare. While some people may rely on integrative medicine to treat a chronic condition, others may simply prefer a more natural way to heal their mind, body, and soul. Your benefits package must meet all your employees’ healthcare needs to become a truly inclusive employer.

Health insurance coverage for integrative therapies is still limited in the U.S. That’s why offering your employees an HRA is a great way to help them pay for their holistic medicine treatment. With PeopleKeep’s benefits administration software, we make it easy to manage your HRA in just minutes each month.

Schedule a call with a personalized benefits advisor today to learn how to add HRAs to your benefits package!

1. https://www.bloomberg.com/news/articles/2019-02-24/spain-tops-italy-as-world-s-healthiest-nation-while-u-s-slips?leadSource=uverify%20wall
2. https://www.abpsus.org/integrative-medicine-now/
3. https://www.nih.gov/news-events/news-releases/according-new-government-survey-38-percent-adults-12-percent-children-use-complementary-alternative-medicine
4. https://www.healthyagingpoll.org/reports-more/report/use-and-interest-integrative-medicine-strategies
5. https://www.nccih.nih.gov/health/paying-for-complementary-and-integrative-health-approaches