It’s not a prescription that a doctor can write. It's not something insurance will usually pay for. But more patients are finding out how horseback riding, or even just being around the animals, can help them feel better.
Mike O’Neill is beginning treatment for prostate cancer at Tampa Bay Radiation Oncology. During a recent appointment, he saw a brochure that advertised a visit to Rockin’ Horse Farm in New Port Richey.
"We like to go to the horse races and the dog races, but to actually get up close and personal doesn't happen too often,” O’Neill said.
He and his wife are self-proclaimed animal lovers, but don’t have any pets of their own. They brought their son and two grandchildren who were visiting from Pennsylvania to the farm.
“He's trying to keep busy to keep it (his cancer) off his mind,” said his wife, Dianne.
O'Neill wasn't at the farm for physical therapy; he got the therapeutic benefits of having a day that wasn't focused on his illness. That’s exactly the point, according to Dr. John Koval of Tampa Bay Radiation Oncology.
"Particularly our patients with cancer, you just want them to have as much in the way of positive experiences as possible,” Koval said. “If this is something that can bring a smile to their face by working with the horses, and they can get a little exercise at the same time doing it, then that's just great."
The O’Neills said it took an hour to drive from Brandon to the farm, where they toured the barn and groomed a horse, something they had never done before.
On that day, Rockin’ Horse Farm was an oasis of sorts, a calm and peaceful place to spend time and be around animals. On other days, the farm serves another purpose, offering another kind of therapy with horses, called hippotherapy. The unfamiliar term has nothing to do with hippopotamuses.
"You can find incidents of hippotherapy back in the Greek literature in the writings of Hippocrates but 'hippos' itself means horse in Greek,” Koval said.
Koval explained that the movements of a horse's hips mimic the movement of a human's hips, which is why the therapy can be so effective for patients who need to build up strength throughout their body.
The treatment is considered experimental. In general, most insurance doesn't cover it. But Amy Baird, who runs Rockin' Horse Farms, has seen it work firsthand.
"For people who have issues with the spine, there's nothing better than horseback riding,” Baird said. “We've had a student with scoliosis who has had part of her condition corrected with horseback riding."
Baird also said they have had students with autism who have said their first words on the back of a horse. But since most companies won't pay for it, Baird said she tries to keep the cost low because she knows families are paying for the treatment out-of-pocket.
None of the insurance companies who responded to inquiries from Health News Florida about coverage for hippotherapy said it was something they typically cover.
"Cigna does not cover hippotherapy because it’s considered to be experimental, investigational or unproven," Mark Slitt wrote in an email. "There are some exceptions when a plan sponsor (employer) chooses to include coverage, but the standard policy is no coverage for this treatment."
Among some of the other companies that do not cover hippotherapy are Florida Blue, Humana, UnitedHealthcare and Aetna, which developed its policy because of a lack of scientific evidence on the therapy's effectiveness.
WellCare, which administers plans for the Florida Medicaid program, referred questions to the Florida Agency for Healthcare Administration. AHCA did not reimburse the state Medicaid plan for the treatment in 2011 or 2012, according to spokesperson Shelisha Coleman, but through the Medicaid Waiver program, the treatment could be covered for some patients.
"Medically necessary hippotherapy services can be offered to a recipient through the Developmental Disabilities Home and Community Based Waiver’s Consumer Directed Care Plus (CDC+) program option," Coleman explained.
Lynn Bankston of Quantum Leap Farm in Odessa said she has worked with several patients whose insurance companies have paid for the treatment, even though the company's standard policy is not to reimburse them.
She said it is often more trouble than it's worth to try to convince the insurance companies to pay for it, but it's not unheard of.
"It's a battle," said Bankston, who said some companies are willing to make it happen. "It's pretty tedious to bill."
More information about the research being done on this type of treatment is available from the American Hippotherapy Association.