1 / 32

What Else Does ACA Have To Say About Licensed Healthcare Providers ?

What Else Does ACA Have To Say About Licensed Healthcare Providers ?. John Weeks Executive Director Academic Consortium for Complementary and Alternative Health Care Publisher, Editor The Integrator Blog News & Reports National Association of Certified Professional Midwives Webinar

eze
Download Presentation

What Else Does ACA Have To Say About Licensed Healthcare Providers ?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. What Else Does ACA Have To Say AboutLicensed Healthcare Providers? John Weeks Executive Director Academic Consortium for Complementary and Alternative Health Care Publisher, Editor The Integrator Blog News & Reports National Association of Certified Professional Midwives Webinar July 24, 2014

  2. Overview • A bit about ACCAHC • Action related to specific language • Action on some useful other themes • “Transformational” or “paradigm” shifts? • Ideas for CPMs www.theintegratorblog.com

  3. Licensed Integrative Health & Medicine “CAM” Disciplines Core 5 with a U.S. Dept. of Education-recognized Accreditation Agency *Of the roughly 1400 schools, the number accredited via the US Dept. of Education-recognized specialized accrediting agency. Source: Modified from ACCAHC’s Clinicians’ & Educators’ Desk Reference on the Licensed Complementary & Alternative Healthcare Professions (2014)

  4. ACCAHC Base: Core Organizational MembersOne of the most enduring, formal interprofessional collaborations in the US

  5. Key Strategic Initiatives Competencies for Optimal Practice in Integrative Environments Promote “researching the way we practice” and increasing capacity Impact critical dialogues Advance Interprofessional respect and inclusion (IPE/C) Gain recognition of our workforce contributions Competency 6 Competency 5 Provide Leadership

  6. Integrative Health & “CAM” in the (PP)ACA

  7. Thanks to US Senate Integrative Health Champions Seeded Opportunity in the Affordable Care Act • Tom Harkin (D-Iowa) • Barbara Mikulski (D-MD) • Bernie Sanders (I-VT) • Kent Conrad (D-ND) • Maria Cantwell (D-WA) • Direct-entry midwives The consumer movement and the US Senate Appropriations Committee …

  8. Section 6301: Patient Centered Outcomes Research Institute (PCORI) Board will include “State-licensed integrative health care practitioner” ... “experts in integrative health and primary prevention strategies” • Viewed as closer to patient-centered and outcomes focus of optimal IHM research • Specific charge to explore “CAM” • Special presentation to Board, 12/2011 • Goertz is one of 19 Governors • Oversee $650-million a year of comparative effectiveness research • Goertz: Chair, PCORI Program Development Committee (former) • Goertz: Chair, PCORI Science and Oversight Committee (current) • CEO met with ACCAHC Research Working Group; asked for an appointment to a committee Board of Governors Member Christine Goertz, DC, PhD Vice Chancellor, Palmer College

  9. National Prevention, Health Promotion and Public Health Council Advisory Group on Prevention, Health Promotion and Integrative and Public Health • Report includes multiple references to “CAM” • 4 known IHM members, of 22 • Working Group on Integrative Health • Sent letter of concern to HHS on Section 2706 (April 2013) • Letter also urged adherence to Section 5101 (Workforce) • Links IHM to prevention and health promotion Charlotte Kerr, RN, MPH, LAc Dean Ornish, MD Sharon Van Horn, MD, MPH Janet Kahn, PhD, LMT Graduate, U Az Fellowship in Integrative Medicine Janet Kahn, PhD, LMT

  10. Section 3502: Community Health Teams/Patient-Centered Medical Homes … “may include doctors of chiropractic, licensed CAM practitioners …” • New models foster team care • Major backing from employers, agencies • Part of effort to move $ and investment toward primary care • Role of IHM is to position themselves as part of solution - examples • F4CP and chiropractors • PIHTA and ACCAHC disciplines Major report on DC role in PCMHs ACCAHC project to elevate potential value

  11. Section 5101: National Health Care Workforce Commission … ““doctors of chiropractic … ” “licensed CAM providers, integrative health practitioners…” • Never funded • Law, nevertheless, is useful and has been cited • AAMC’s shift from “physician” to “health workforce” – M Lawlor present May meeting • ACCAHC, now ACCAHC-IHPC primary care/”primary maternity care” project Meeting the Nation’s Primary Care Needs: The Current and Prospective Roles of Doctors of Chiropractic and Naturopathic Medicine, Practitioners of Acupuncture and Oriental Medicine, and Direct-Entry Midwives Association of American Medical Colleges ACCAHC document, developed with MEAC as partner

  12. Other A.C.A.-RelatedUseful Federal Policy Initiatives

  13. Movement Toward Team Care/Interprofessional Practice and Education (IPE) Mary Wakefield, RN, PhD, Administrator, HRSA Barbara Brandt, PhD, Center Director • Interprofessional Education Collaborative – Core Competencies for Interprofessional Collaborative Practice (2011) • $13.5-million National Center for Interprofessional Practice and Education (HRSA, foundations) (2012) • American Association of Medical Colleges MedPortal on IPE (with psych, PT, PA) (2012) • IOM Global Forum on Innovation in Health Professional Education (includes integrative health/CAM) (2012) IPE is “patient-centered” and promotes “egalitarianism” among disciplines

  14. ACCAHC IPE/C Action in Multiple Initiatives Inclusion of licensed IHM, health creation Focus on inclusive teams, inclusion of “CAM” Focus on self-care health & well-being John Gilbert, PhD: ACCAHC Keynote (2011) and Council of Advisers member Endorsement of IPEC competences as part of ACCAHC’s Promoting an IPE and inclusive view of integrative medicine Create, manage IPE page; promote IPE/C focus Stimulated over 40 orgs and individuals to “join” Promote/support NCIPE’S Barbara Brandt & JIHC Scott Reeves as keynoters Change definition from “therapies” to IPE language Sarita Verma, MD, JD: ACCAHC Keynote (2013) and Council of Advisers member

  15. A.C.A. and Integrative Pain • Funds Institute of Medicine (IOM) Committee on Advancing Pain Research, Education and Care • Member: ND, LAc pain expert Marinelli • Member: UCLA Integrative pediatrician Zelzer • IOM “Blueprint” (2011) includes “CAM” in 15 segments Plus, Pain focus in NCCAM Strategic Plan • Highlighted in Strategic Objective #1 • New NCCAM pain-military effort (July 2014) Rick Marinelli, ND, LAc Lonnie Zelzer, MD

  16. Integrative Health Care and the Military Motivation • Performance/functional priority • Soldiers, like actors, athletes • “The Imperative for Integrative Medicine in the Military” • Schoomaker, May 2014, IRCIMH • Pressure from chiropractors • Success creates openings for others • Current use (2012) • 120 facilities offer 275 ‘CAM’ programs and 213,515 (Dept. of Defense report to Congress, January 2014) Anthony Lisi, DC, Director VA-chiropractic program Former US Army Surgeon General Eric Schoomaker, MD, PhD

  17. Integrative Care Leader at Veteran’s Affairs Former IM leader at Weil/U Arizona & Duke selected to direct VA Office of Patient Centered Care and Cultural Transformation “ [The Office will be] a living, learning organization in which we will discover and demonstrate new models of care, analyze the results, and then create strategies that allow for their translation and implementation across the VA.” Tracy Gaudet, MD Former Director of IM at U Arizona and at Duke

  18. “Transformational?”

  19. Shifting Incentives “When I first heard of integrative medicine in 2006, I thought of it as an expense … Ken Paulus, CEO, Allina Health System Weeks J. Health System & Military Leaders Say Cost and Pain are Motivating Inclusion of Integrative Medicine http://theintegratorblog.com/index.php?option=com_content&task=view&id=795&Itemid=189 Ken Paulus, CEO Allina Health System

  20. Shifting Incentives “… but as the Affordable Care Act's payment structure kicks in that supports keeping people healthy, integrative medicine will be an asset.“ Ken Paulus, CEO, Allina Health System (2011) Weeks J. Health System & Military Leaders Say Cost and Pain are Motivating Inclusion of Integrative Medicine http://theintegratorblog.com/index.php?option=com_content&task=view&id=795&Itemid=189 Ken Paulus, CEO Allina Health System

  21. Is this values framework conducive to midwifery and integrative health outcomes?

  22. Typical “Hot-Tub Claims” of Integrative Healthcare Practitioners #1 So, what is your value to your patients? After my care, my patients: • Can do more things • Aren’t in as much pain • Suffer fewer adverse effects • Have more energy • Enjoy things more • Feel better Integrator Blog News & Reports www.theintegratorblog.com

  23. Typical Hot-Tub Claims of Integrative Healthcare Practitioners #2 So, what is your value to the system? My services: • Diminish use of pharmaceuticals • Lower adverse effects of pharmaceuticals • Limit needs for more expensive conventional tests and services • Lower costs Integrator Blog News & Reports www.theintegratorblog.com

  24. Collaborate& Engage -Data -Best practices -Webinars -News pushes -Face-to-face www.optimalintegration.org

  25. The Emerging Opportunity: Creating Health

  26. Perlin/AHA: “We Don’t Fully Understand the Recipe” Jonathan Perlin, MD, PhD Chair-Elect, AHA CMO, HCA "From Sick Care to Health Care" “We have been honed to focus on sick care … It is a tough transition, but we have to learn how to move from sick care to health care. "I'm not sure that any of us … fully understands or knows the recipe."

  27. Mayo: From “Producing Health Care” to “Creating Health” Douglas Wood, MD Director, Strategy and Policy Mayo Clinic Center for Innovation "We are realizing fairly quickly that we need to change the focus of the health care industry to creating health, not just producing health care." American Hospital Association's Hospitals and Health Networks, April 2013 http://www.hhnmag.com/display/HHN-news-article.dhtml?dcrPath=/templatedata/HF_Common/NewsArticle/data/HHN/Magazine/2013/Apr/0413HHN_FEA_PatientexperienceGate

  28. Berwick: “Radical Shift” Toward “Creating Health” Don Berwick, MD Former CMS Administrator Past CEO, Institute for Health Improvement “It is fortunately commonplace now to say that we would be better off to re-direct some of our health care enterprise from fighting illness … to health creation." "The pursuit of health, the creation of health, may require … a redesign that may be even more radical than we have imagined." Plenary Panel, Institute for Health Improvement, December 2013 http://www.youtube.com/watch?v=r5Tbikk44jY Also: “Hooking Up: Don Berwick, Integrative Medicine and His Call for a Radical Shift to 'Health Creation‘” http://www.huffingtonpost.com/john-weeks/don-berwick-integrative-m_b_4781105.html

  29. Recommendations for Midwives • Get out of your silos (and related attitudes) • Educate for team practices (even if virtual) • Gain competencies for practice in integrated environments • Form inter-professional networks in your communities • Gather and publish Triple Aim outcomes • Collaborate in policy with those with like values Campaign with others to research and promote the concept of “conservative treatment” throughout medicine

  30. Thank You! jweeks@accahc.org www.accahc.org www.optimalintegration.org Facebook: Center for Optimal Integration LinkedIn: Project to Enhance Research Literacy LinkedIn: Project for Integrative Health and the Triple Aim Twitter: #CentOptInt

More Related