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Medicare Covers Yoga for Heart Disease
by
William Hudson, CNN
February 27, 2012
Picture Credit:
www.cnn.com
Frank Korona
lives near the West Virginia-Pennsylvania border with his wife Kathy,
in a house that he built with his own hands, on the same property where
he grew up.
He served in the Army Special Forces in Vietnam. The Koronas have a
long, proud tradition of military service, but their family's greatest
losses have been to heart disease.
"Our family has shrunk tremendously. We've lost so many people through
death," Kathy says.
In 1992, Frank's brother Bob died in his arms, suffering a heart attack
on their kitchen floor. Parents, siblings, aunts, uncles and cousins
have all died from complications from heart disease, too. The Koronas
point them out in a graveyard near their home.
Frank and Kathy have both had heart attacks, and both have stents
holding their blood vessels open. The birth of their grandson Caleb led
them to try harder to extend their lives. So last year, the couple
joined the Dean Ornish Program for Reversing Heart Disease.
Medicare, the government health insurance program for Americans 65 and
older, covers the Ornish program, which teaches a plant-based, meatless
diet, meditation and regular exercise. The program was officially
declared an intensive cardiac rehab program in 2010, and the first
patients started in May 2011.
Ornish is a persistent advocate within the halls of government. There
are mountains of scientific evidence that his recommended lifestyle
changes do reverse heart disease, the No. 1 killer in the United States
and worldwide.
Helping patients make these lifestyle changes costs Medicare about $70
per hour, and patients can receive up to 72 one-hour sessions.
Proponents of preventative medicine point out that that cost is still
much less than operations and medications.
Ornish believes that fear cannot motivate lifestyle change in people
long-term. Change has to be about feeling better and having more zest
for life. The greater the change, the better the feeling, he says.
That seems to ring true for the Koronas. Despite the grim history of
heart disease, they say it's how good they feel that keeps them living
the lifestyle that their neighbors sometimes find strange.
"If I was going to be able to participate as a grandparent in his life,
that gave me another incentive, that really did," Kathy explains. "But
in order to do that, I needed to feel good about myself first."
The Koronas' favorite yoga positions are "cobra" and "fish," and their
favorite pizza is meatless meat-lovers, made with soy pepperoni and soy
"ground beef."
"Usually at the end of the session, the instructor will say, 'Now the
reward, get into the total relaxation pose,' and we do that, and it
just feels so good," Kathy says.
Together the Koronas have lost 85 pounds on the program, and Frank is
off of four medications.
Hospitals can now bill Medicare for their patient's yoga and group
discussion sessions because the Ornish program is an approved intensive
cardiac rehab program, a new class of cardiac rehab created by Congress
in 2009.
Traditional cardiac rehab, developed in the 1950s and covered by
Medicare since 1982, focuses almost exclusively on exercise -- getting
patients out of bed and the blood flowing again.
But in the 1970s, Ornish and others began leading experiments to test
whether improving diet and stress levels could make a difference for
those with heart disease. In the following decades the researchers
published volumes of studies in peer-reviewed journals that became the
basis of the Dean Ornish Program for Reversing Heart Disease.
There are four components to the program: nutrition, stress management,
moderate exercise and group support.
Part of the underlying cause for widespread heart disease, explains
Ornish, is chronic loneliness and isolation, which lead to stress and
bad habits. When people feel emotionally close to others, they're
physiologically healthier, too, so Medicare is paying for it.
"The reason that I spent 16 years working with the Centers for Medicare
and Medicaid Services to achieve Medicare coverage for our program is
that I knew that most insurance companies follow Medicare's lead. In
other words, if Medicare covered our program, most other insurance
companies would, as well," explains Ornish, who also says he was once
naive in thinking that solid science alone would be enough to change
health care policy.
"Reimbursement as well as science are primary determinants of medical
practice. If it's not reimbursable, it's not sustainable."
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