Alternative Goes Mainstream

But while most health plans cover select services like acupuncture or chiropractic care, integrative medicine is largely a cash business. Corvino hopes third-party payers will eventually understand the long-term savings of keeping patients healthy now rather than treating them later. Greenwich charges patients on an hourly basis based on the type of service, which offers flexibility for out-of-town patients. Rather than scheduling frequent short appointments, visitors can do fewer but more extended visits to address as many issues as possible. Patients receive an itemized "super bill" that provides ICD and CPT codes for patients who want to seek coverage from their insurance companies, says Henri Roca, MD, medical director of Greenwich's Center for Integrative Medicine.

"We do let them know that insurance companies aren't used to dealing with this level of care and to have their expectations tempered," Roca says.

Searching for profits

Although Greenwich's integrative medicine program brings in patients, the bottom line impact has been minimal, Corvino says; he estimates that the new outpatient center will take three years to become profitable. Hospital leaders who've had success with integrative medicine programs say location and market knowledge are crucial for profitability. In other words, facilities that offer an array of alternative services must be able to attract patients who can pay for them. This is not a problem in Greenwich, an affluent community where the estimated median household income tops $110,000. But Hartford Hospital, a 710-staffed-bed urban hospital in Connecticut's second-largest city, knows the challenges of finding and keeping patients.

Hartford's department of integrative medicine provides services (massage, acupuncture, and Reiki), community education (lectures on wellness topics), and teaching (training and guidance to other hospitals), says Vice President Kevin Kinsella. The service component pays for itself through fees, but the costs of constant community education and outside teaching--components needed to attract new customers--are grant-funded. To simplify the program's operations, Hartford uses independent practitioners and volunteers. All services are done on a cash basis.