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Funded Retirement and Insurance Committee Minutes April 7, 2011, 12:00 am 302 USB Funded Retirement and Insurance Committee (FRIC) Meeting

April 7, 2011

Meeting called to order at approximately 12:00 Noon in Room 302 USB.  Note – this was a special meeting of FRIC with Nicole Nisly, MD, UIHC Internal Medicine to provide information to the committee about complementary and alternative medicine.

Members present:     Nancy Davin, Matthew Glasson, George Herbert, Sheldon Kurtz, Heather Schnoebelen, Bernard Sorofman, Lynn Vining, Dagong Wang and Michael Wichman

Members absent:       Jon Garfinkel, Daniel Katz, Victoria Sharp, Katherine Tachau and Anand Vijh

Administration:         Sue Buckley, Richard Saunders

Guests present:          Carol Fethke, Dan Fick, Amber Goedken, Suzanne Hilleman, Debra Hughes, Christine Miller, Nicole Nisly, Dick Stevenson, Joni Troester, and Dianne Wasson

1.  Committee members, administration representatives and guests introduced themselves.

2.  March 4th Minutes were approved with changes noted by Nancy Davin, date corrected and a clarification to the third paragraph under item 4 that UIHC sets the co-pay.

3.  Alternative Medicine - Dr. Nicole Nisly from the Department of Internal Medicine gave a presentation to the group about alternative medicine explaining that alternative medicine includes a broad range of therapies encompassing older established therapies such as acupuncture to new emerging techniques such as energizing therapies. Alternative medicine is not typically part of the traditional western medical system.  Alternative or complimentary medicine is typically used by higher educated individuals, women and those that whose incomes are greater than average.  Iowa City is a typical place where alternative medicine would be used by residents.  She explained that there are several basic types of complementary and alternative medicine, 1) biological based practices that include herbs, dietary supplements, foods and vitamins, 2) manipulative therapies which includes massage or chiropractic treatment, 3) mind-body medicine that includes meditation, yoga and acupuncture, 4) others such as homeopathic and energy therapies involving electromagnetic fields such as magnet or light therapy.

Dr. Nisly further explained that the UI started a small alternative care program in 1998 with her clinic providing guidance and consultative services to patients.  Her patients include those dealing with radiation and chemotherapy treatments and seeking ways to deal with chronic pain.  People are willing to spend money for alternative and complimentary medicine to support smoking cessation for example.

Insurance coverage for alternative and complementary medicine is limited.  Most complimentary medicine services are provided as outpatient services.  In some cases alternative medicine provided as in-patient services are covered by insurance.  There is evidence indicating that patients that receive alternative medical services result in decreased time in the hospital.  In some instances alternative medical treatments may be covered by insurance, for example music therapy, acupuncture, yoga, etc. for patients dealing with cancer.

Dr. Nisly answered several question posed by committee members associated with the safety, efficacy, evidence and education supporting alternative medicine.  Committee discussed what types of alternative medicine is currently covered such as chiropractic care by law in Iowa, what could be covered, licensure requirements in Iowa and how to design and structure program for alternative medicine.  Potential options include 1) cover alternative medical treatment for everyone, 2) limited coverage for alternative medical coverage, e.g., acupuncture, massage therapy, etc., 3) physician prescribed and 4) condition specific.  There are obviously costs to including coverage, but there is also evidence that in some cases alternative medical treatments save costs.  Committee discussed potential of piloting for a year and obtaining data related to costs, cost savings and decrease in length of stay.  Dr Nisly stated that she will be available to meet with the committee again next year and supplied the following links to resources for the committee.

Link to UIHC Complementary and Alternative Medicine web site:

http://www.uihealthcare.org/Clinic.aspx?id=3499

Subsequent to the committee meeting Dr. Nisly provided the following additional information to the committee:

What is CAM (complementary and alternative medicine): http://nccam.nih.gov/health/whatiscam/

Use of CAM:
http://nccam.nih.gov/news/camstats/2007/camsurvey_fs1.htm Video

lectures and review of evidence: http://nccam.nih.gov/training/videolectures/ Some select results of NIH

sponsored CAM research and literature analyses: http://nccam.nih.gov/health/providers/evidencebased.htm Academic

Consortium of Integrative Medicine: what other academic hospitals are doing: http://www.imconsortium.org/members/home.html

A non academic hospital example: Abott Nortwest Hospital in MN http://www.abbottnorthwestern.com/ahs/anw.nsf/page/ihh_home

Iowa Medical Board Position or regulation on Naturopathy:  http://www.state.ia.us/ibme/policies/naturopathy.html

4.  Wig Coverage – Committee discussed whether wigs should be included as part of insurance package available to employees.  There are two basic types of wigs, synthetic and human hair with the human hair wigs being considerably more expensive.  At the low end, synthetic wigs cost approximately $45 while human hair wigs cost approximately $1,100.  According to Wellmark, several employers cover the cost of wigs for patients dealing with hair loss due to medical treatments.  Generally the employer pays 80% and employee pays 20%.  Estimate of cost to university was raised and less than 200 university employees currently meet Wellmark requirements for coverage.  Committee requested copy of Wellmark guidelines for coverage, an estimate of cost to provide coverage effective 01/01/2012.  Further discussion and possibly final decision whether to support will be made during the May meeting.

6.         The meeting adjourned at approximately 1:00 p.m.

Next meeting – Friday, 05/06/11, 11:30 a.m. – 1:00 p.m., Room 302 USB

Respectfully submitted,

Michael D. Wichman