Now that the presidential election is over and President Obama has been elected to serve a second term, the future of the Affordable Care act is no longer in question. This historic legislation has the potential to substantially redirect the nation’s healthcare delivery system toward a focus on health rather than on disease. A petition has been posted on the "We the People" website asking the government to include NDs as primary care providers under the Affordable HealthCare Act (aka Obamacare). The ACA already includes a number of opportunities for complementary and alternative healthcare providers, if it is implemented as intended. If substantial support is gathered, the petition will open further opportunities for naturopathic physicians to be involved in discussions about specific implementation policies. Support the petition here.
Curious how naturopathic physicians and other licensed CAM providers fit into the Affordable Care Act? Read on...
The Integrative Health Policy Consortium released a report with recommendations specific to 6 sections of the ACA where CAM providers can best contribute to transforming healthcare. These include Section 2706, the “non-discrimination clause”; Section 3502, which establishes community health teams in Patient-Centered Medical Homes; Section 4001, which created The National Prevention, Health Promotion, and Public Health Council; Section 4206, which calls for demonstrations projects concerning individualized wellness plans; Section 5101, which define providers eligible to participate in the National Health Care Workforce Commission; and Section 6301; which established the Patient-Centered Outcomes Research Institute. The figure illustrates specific strategies as recommended by the IHPC.
The petition calls for inclusion of naturopathic physicians as primary care providers. This could be accomplished through implementation of regulatory language providing specific examples of insurance company actions that are prohibited or permited under ACA Section 2706. The decade of inclusion of CAM providers in Washington State under the "Every Category of Provider Law" provides policy-makers an example of what could be expected at a national level if implementation of Section 2706 happens as intended. Recent highlight of broad inclusion in Washington included top ranking in all 4 "Patient Experience" metrics as reported by the Puget Sound Health Alliance's survey of 90,000 patients about their care in 40 major clinics in the Puget Sound. Another key opportunity for naturopathic primary care exists in the establishment of Patient-Centered Medical Homes. This could be partially addressed with regulatory language that ensures definitions of "integrative healthcare practitioners" are clearly inclusive of naturopathic physicians and all licensed CAM providers. Naturopathic primary care physicians are willing and qualified providers to serve under the National Health Care Workforce Commission and specific inclusion would contribute to reversing the epidemic shortage of primary care providers. In fact, surveys of naturopathic medical students suggest the majority of graduates are interested in serving as primary care providers in rural and underserved communities; service that would be incentivized with inclusion in medical loan repayment programs. To learn more, see the Academic Consortium of Complementary and Alternative Health Care (ACCAHC), the Integrative Health Policy Consortium, and commentary at the Integrator Blog.
The above examples are only a few of the opportunities for increasing patient access to licensed complementary and alternative medicine providers through the Affordable Care Act. Your support of the whitehouse.gov petition will send a message that you want to see the Affordable Care Act implemented as intended with broad inclusion of integrative healthcare providers including naturopathic physicians.
Erica Oberg, ND MPH, Director, Center for Health Policy & Leadership, Bastyr University