RESUMEN
Methods: Databases were searched using CPT codes (acupuncture, chiropractic, and massage therapy), clinic stop codes (chiropractic care), clinic location names, internal accounting codes, clinic note titles, and structured coding templates (Health Factors) unique to VHA's electronic medical record. Results: A total of 441,891 Veterans used 2,930,700 of these services in FY20, representing a slight decrease from FY19 (3,083,806 total visits). Prior to the COVID19 pandemic, VHA was on track for expanded utilization in FY20. Of these visits, 422,313 (14%) were delivered through telehealth. Over 8.1% of all Veterans receiving VHA care in FY20 received at least oneCIH therapy, Whole Health service, or chiropractic care service. Use was highest among women (14.3%), patients with chronic pain (18.1%), opioid use disorder (15.6%), rheumatoid arthritis (13.3%), obesity (12.9%), or a mental health condition (12.8%). VHA medical centers worked quickly during the pandemic to expand telehealth offerings;comparing against FY19, nearly onethird of the monthly in-person visit volume was provided through telehealth by the end of 2020 for therapies including Core Whole Health services, yoga, Tai Chi/Qigong, meditation, biofeedback, guided imagery, and hypnosis. Background: Given that VHA is the largest healthcare system provider of CIH therapies in the U.S., we examined the VHA's national provision of nine CIH therapies (acupuncture, battlefield acupuncture, biofeedback, clinical hypnosis, guided imagery, massage therapy, meditation, Tai Chi/Qigong, and yoga), chiropractic care, and Whole Health services for fiscal years (FYs) 2017 to 2020 using data from electronic medical records and community-based claims, and assessed utilization as VHA expanded CIH offerings and pivoted to tele-CIH and tele-Whole Health in response to the COVID19 pandemic. Conclusion: Despite the impact of COVID19 on reduced FY20 in-person visits, including group CIH therapies, VHA continued to provide nearly the same number of visits as the prior year, in part due to expansion of telehealth services.