Practitioners Face Reimbursement Barriers for Lifestyle Medicine Interventions

Research results show that many physicians and other clinicians are hindered from helping patients make these changes.

A survey of 1286 practitioners shows that 55% reported not receiving any reimbursement for lifestyle medicine practices, while 27% reported some reimbursement and 18% being reimbursed for all their lifestyles medicine interventions, according to research results from the American College of Lifestyle Medicine.

The respondents included dietitians, nurse practitioners, physician assistants, physical therapists, and physicians.

The respondents shared specific examples of both clinician and patient barriers, such as a Medicare patient who was denied coverage for a nutrition-focused weight management program in favor of a costly surgical procedure.

“Chronic disease management guidelines clearly recommend health behavior changes, but many reimbursement barriers discourage or prevent health care practitioners from helping patients achieve those lifestyle changes,” study author Kelly Freeman, MSN, AGPCNP-BC, DipACLM said in a statement. “If optimal health outcomes are truly the goal, more resources are needed to best illuminate the most impactful types of lifestyle interventions and how to successfully implement them in a sustainable manner.”

Some survey respondents recommended several changes that would improve their ability to practice lifestyle medicine. The top suggestions included better electronic medical record capabilities, policy changes to incentivize improved health outcomes and lifestyle medicine-specific billing codes, and reimbursement for increased time spent with patients.

The study authors proposed that specific policy changes must change to address the limitations of the payment and reimbursement models. A proposal example is to develop new quality measures that emphasize clinical outcomes and patient experience to address chronic disease remission and reversal.

“Now is the time to acknowledge that lifestyle medicine treatment is high-value care,” Micaela Karlsen, PhD, MSPH, ACLM Director of Research, said in the statement. “Practitioners who are able to achieve outcomes such as type 2 diabetes remission, true improvements in well-being, and reductions in medications, should be paid for their services in a manner that is commensurate with the value they provide.”

Reference

Reimbursement struggles for lifestyle medicine interventions pose significant barrier for health care practitioners, study finds. EurekAlert! News release. November 15, 2021. Accessed November 17, 2021. https://www.eurekalert.org/news-releases/934904