variety of patients including university employees and students from nearby Ithaca, N.Y., and local Amish families. Alternative healthcare has already come to Schuyler with its freestanding birthing center, staffed by three midwives.
"We opened the birthing center after clients' requests," Hall said. "It's 200 yards from the hospital, which is handy if there was an emergency. We would want our holistic center to be client-centered, as well."
AHC's four volumes of material show prospective holistic center developers everything they need to know, from practitioner recruitment to reimbursement issues to dealing with a medical staff.
Costs of constructing a center or renovating an outpatient office for alternative medicine uses could cost $150,000 to $250,000. In addition, AHC charges a $25,000 licensing fee plus 3% of any revenues a holistic center would collect.
AHC said it will negotiate a joint venture or let the hospital own the facility.
But adding a holistic center to a part of a hospital or healthcare system won't be without controversy.
"Keeping the site away from the hospital avoids a lot of political problems," Edelberg said. "There's always going to be a physician on the hospital medical staff who will take off his shoe and bang it on the boardroom table if there's a chiropractor (on the hospital staff)."
Many physicians and insurers remain leery of alternative healthcare.
Louisville, Ky.-based Humana only insures forms of alternative healthcare mandated by states where it has enrollees.
"It's been drawn to our attention only through state mandates, but that's about as far as we've been involved," said Ron Lankford, M.D., vice president of medical affairs for Humana. "I haven't been approached by enrollees. If it becomes an important marketplace issue, we'll be responsive to that."
In hopes of muting their critics while keeping providers interested, AHC requires a physician be on any center's staff as a medical director. Other holistic practitioners must be licensed.
"If you go to Chinatown for an acupuncture, how do you know that the guy is a licensed practitioner of 30 years or someone off the street," said Kirk Moulton, AHC's chief executive officer. "People are already getting this care and we want to provide oversight."
Supporters of alternative healthcare are excited about the federal government's increasing support. A House subcommittee this month approved a budget of $7.5 million in fiscal 1996 for the National Institutes of Health's Office of Alternative Medicine. That's up from $2 million when OAM was created in 1992 and up from the fiscal 1995 appropriation of $5.4 million.
That support comes on the heels of the NIH's first research report released earlier this year on alternative healthcare, a 420-page compilation of 200 medical professionals' research.
All 50 states have some sort of licensing standards for holistic practitioners, but not all the states require insurers to cover treatments. To help coordinate these diverse efforts, AHC is developing a database for its clients to measure quality and provide a national clearinghouse for holistic-care practices.
For example, fewer than 10 states require private health insurance companies to cover acupuncture, while 41 states require coverage of chiropractic care. More than 46% of all HMOs cover chiropractic care, according to the Group Health Association of America.
The Health Insurance Association of America said there aren't mandates specifically mentioning holistic healthcare. "As a general rule, insurers will pay for care if it is deemed medically necessary and is prescribed by a duly licensed practitioner," the HIAA said in a statement.
AHC expects by next year to have developed through its affiliates software for billing, protocols, clinical outcome studies and practice management.
AHC executives say it's too early to tell how much revenue a hospital or physician group could generate from a holistic center, but they believe the ventures will be cost-effective.
Executives said they expect to make an initial public stock offering in three to six months. They are negotiating with venture capitalists in Chicago but aren't ready to disclose which firm, they said.
AHC believes consumer interest will drive potential growth.
"If you are looking at re-engineering your system for the 21st century, look at customers first," Edelberg said.
"Holistic centers work in a cost-conscious system. Instead of referring upward to a specialist, you're referring laterally to a holistic practitioner where your costs are a fraction of what they would be," he said.
As an example, Edelberg cites a $40,000 surgery to cure chronic back pain. Meanwhile, that same patient could have chiropractic and acupuncture care that would cost $400 for a four-week treatment.
"An insurer looking at those kinds of savings can't help but offer alternative therapies as part of their health plan's menu," said David Harrington, a healthcare consultant with Karen Zupko & Associates, a Chicago-based firm.
"Bringing holistic care into the mix provides a value-added benefit to a health plan," Harrington said.
At AHC's model Chicago Holistic Center, 70% of the billings have been paid through insurance, according to a 15-month internal study.
There's evidence other insurers are looking at forms of holistic healthcare. Mutual of Omaha covers the $3,500 cost of a 12-week program designed to reverse heart disease. The plan-which was created by diet expert Dean Ornish and includes stress management, diet and exercise-is aimed at avoiding heart surgery that could cost more than $40,000.
Health plans and providers that try reaching out to holistic patients are going to like them, Edelberg said.
"Our patients are educating themselves on something new so they follow instructions and they pay the bill," Edelberg said. "The holistic patient wants to nip things in the bud. (Such a patient is) a provider's dream."