Can Yoga, Mindfulness Fit With Managed Care? | Page 2

Recent studies have linked yoga and mindfulness with reduced stress, improved glycemic control, and even lower medical costs. Should these low-cost practices find ways to standardize to meet payers' needs? Or is it managed care that needs to adapt?
Published Online: March 03, 2017
Mary Caffrey
Some experts reject the idea that yoga or meditation should change to fit healthcare—it’s the payers who should adapt, for the simple reason that the practices save money. Findings from an intervention called 3RP—for relaxation, response, and resiliency—found a 43% reduction in healthcare use among participants who took stress-reduction training at the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital (MGH) in Boston.23 The authors emphasize that stress management skills can be taught, and at a much lower cost than treating what stress does to the body.

  Marlynn Wei, MD, JD, a psychiatrist and author of the forthcoming book, The Harvard Medical School Guide to Yoga,24 argues that yoga has the evidence, the cost-effectiveness, and the growing popularity to make it an effective part of preventive care.25 

  A 2016 study commissioned by Yoga Journal and the Yoga Alliance found that while $16 billion was spent each year on classes, clothing, and other costs, most prefer to practice at home (65%).5 Seasoned practitioners can practice effectively by themselves, but it takes time to learn yoga—and cost was the biggest concern in selecting a studio or gym to take classes for half the respondents.5

  “Yoga is the most popular form of mind-body practice in America today,” Wei wrote in a blog post. “That means if yoga was made more affordable and accessible through health insurers, it’s likely many people will actually use this insurance benefit.”25

Mary Caffrey is the managing editor of Evidence-Based Diabetes Management.

  1. Ross A, Thomas S. The health benefits of yoga and exercise: a review of comparison studies. J Altern Complement Med. 2010;16(1):3-12. doi: 10.1089/acm.2009.0044.

  2. McDermott KA, Rao MR, Nagarantha R, et al. A yoga intervention for type 2 diabetes risk reduction: a pilot randomized trial. BMC Complement Altern Med. 2014;14:212. doi: 10.1186/1472-6882-14-212.

  3. Innes KE, Selfe TK. Yoga for adults with type 2 diabetes: a systematic review of controlled trials. J Diabetes Res. 2016. doi: 10.1155/2016/6979370.

  4. Wang MY, Greendale GA, Yu SS, Salem GJ. Physical-performance outcomes and biomechanical correlates from the 32-week Yoga Empowers Seniors Study. Evid Based Complement Alternat Med. 2016. doi: 10.1155/2016/6921689.

  5. Yoga Journal, Yoga Alliance, Ipsos Public Affairs. The 2016 Yoga in America study. Yoga Journal website. Published January 13, 2016. Accessed January 29, 2017.

  6. Cramer H, Thoms MS, Anheyer D, Lauche R, Dobos G. Yoga in women with abdominal obesity—a randomized controlled trial. Dtsch Arztebl Int. 2016; 113(39):645-652. doi: 10.3238/arztebl.2016.0645.

  7. Cramer H, Langhorst J, Dobos G, Launch R. Yoga for metabolic syndrome: a systematic review and meta-analysis. Eur J Prev Cardiol. 2016;23(18):1982-1993. doi: 10.1177/2047487316665729

  8. Moliver N, Mika E, Chartrand M, Burrus S, Haussmann R, Khalsa S. Increased Hatha yoga experience predicts lower body mass index and reduced medication use in women over 45 years. Int J Yoga. 2011;4(2):77-86.doi: 10.4103/0973-6131.85490

  9. Satish L, Lakshmi VS. Impact of individualized yoga therapy on perceived quality of life performance on cognitive tasks and depression among type II diabetic patients. Int J Yoga. 2016;9(2):130-136. doi: 10.4103/0973-6131.183707.

  10. Buchanan DT, Landis CA, Hohensee C, et al. Effects of yoga and aerobic exercise on actigraphic sleep parameters in menopausal women with hot flashes. J Clin Sleep Med. 2017;13(1):11-18. doi: 10.5664/jcsm.6376.

  11. deBruin EI, Formsma AR, Frijstein G, Bögels SM. Mindful2Work: effects of combined physical exercise, yoga, and mindfulness meditations for stress relief in employees. a proof of concept study. Mindfulness (N Y) 2017;8(1):204-217. doi: 10.1007/s12671-016-0593-x.

  12. Chimkode SM, Kumaran SD, Kanhere VV, Shivanna R. Effect of yoga on blood glucose levels in patients with type 2 diabetes mellitus. J Clin Diagn Res. 2015;9(4):CC01-CC03. doi: 10.7860/JCDR/2015/12666.5744..

  13. Daubenmier J, Moran PJ, Kristeller J, et al. Effects of a mindfulness-based weight loss intervention in adults with obesity: a randomized clinical trial. Obesity (Silver Spring). 2016;24(4):794-804. doi: 10.1002/oby.21396.

  14. Forbes B. Yoga and managed care: a cautionary tale. Int J Yoga Ther. 2010; 20(1):22-25.

  15. Caffrey M. Trump calls for letting Americans deduct health premiums, import drugs. The American Journal of Managed Care® website. Published March 3, 2016. Accessed January 29, 2017.

  16. The PHIT (Personal Health Investment Today) Act. PHIT America website. Accessed January 29, 2017.
17. Crane RS, Brewer J, Feldman C, et al. What defines mindfulness-based programs? the warp and the weft [published online December 29, 2016]. Psychol Med. doi:

  18. Loucks EB, Gilman SE, Britton WB, Gutman R, Eaton CB, Buka SL. Associations of mindfulness with glucose regulation and diabetes. Am J Health Behav. 2016;40(2):258-267. doi: 10.5993/AJHB.40.2.11.

  19. Laurence S. The role of outcome-based standards in yoga therapy. Int J Yoga Ther. 2010;20(1):42-51.

  20. Ross A, Birdee G, Touchton-Leonard K, Bevans M. The implementation of patient-reported outcome measures in yoga therapy. Int J Yoga Ther. 2016;26(1):113-121. doi:

  21. Kusnick C, Kraftsow G, Hilliker M. Building bridges for yoga therapy research: the Aetna, Inc., mind-body pilot study on chronic and high stress. Int J Yoga Therap. 2012;22(1):91-92.

  22. Wolever RQ, Bobinet KJ, McCabe K, et al. Effective and viable mind-body stress reduction in the workplace: a randomized controlled trial. J Occup Health Psychol. 2012;17(2):246-258. doi: 10.1037/a0027278.

  23. Stahl JE, Dossett ML, LaJoie AS, et al. Relaxation response and resiliency training and its effect on healthcare resource utilization. PLoS One. 2015;10(10):e0140212. doi: 10.1371/journal.pone.0140212.

  24. Wei M, Groves JE. The Harvard Medical School Guide to Yoga website. 2017. Accessed February 14, 2017.

  25. Wei M. Who should help pay for yoga? The Huffington Post website. Updated November 17, 2016. Accessed January 29, 2017.
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