The Northwestern Health Advocate

Center for Healthcare Innovation and Policy

Stay current with the latest policy and research news in integrative health care

Thanks for reading! The Center for Healthcare Innovation and Policy at Northwestern Health Sciences University is gearing up for a lot of legislative activity in the new year. As such, we've added a regular feature to highlight bills that might be of interest to you, and ideas for how to get engaged. Check out our Call To Action, below!

Healthcare Practice

Increasing Veterans Access to Chiropractic Services

While the Veterans Health Administration often does a tremendous job tending to the diverse health care needs of over 8.76 million veterans annually, it is not without shortcomings. Access to prompt and convenient care remains a barrier to many patients within the system.

To address this, President Obama signed into law the Veterans Access, Choice and Accountability Act (VACAA) of 2014. The law created a Veterans Choice Card benefit, which allows eligible Veterans to obtain approved care from providers within their community, as opposed to at a VA facility. To qualify, Veterans must:

1) live more than 40 miles from a VA facility, and

2) be unable to get a VA appointment within 30 days of their preferred date, or within 30 days of the date determined medically necessary by their physicians.

The Veterans Choice Program benefits Veterans who qualify by increasing their access to quality care, while decreasing the wait list burden within VA medical facilities.

Chiropractic services have been included as part of the standard Medical Benefits Package for all enrolled Veterans since 2004. Since then, Doctors of Chiropractic have affiliations with nearly half of the major VA medical facilities in the U.S.. Hundreds of chiropractic students have learned about complex case management as clerks within the VA medical system. Beginning in 2014, post-graduate chiropractic residents are receiving additional training in integrated clinical practice at one of five VA medical centers. The value of chiropractic care within this system is evidenced by deepening roots for the profession within the VA health care system.

To learn more about how the Veterans Choice program works, and requirements for veterans to participate, visit the U.S. Department of Veterans Affairs website. If you are a chiropractor who is interested in participating as a provider in the Veterans Choice Program, visit Health Net to learn more about the requirements for credentialing.


Complementary, Integrative Therapies Recognized in Fight against Opioid Drug Abuse

Recommendations advocating the use of complementary and integrative therapies were included in a recently adopted American Public Health Association (APHA) policy, “Prevention and Intervention Strategies to Decrease Misuse of Prescription Pain Medications” (20154). Passed during the November 2015 APHA Annual meeting in Chicago, Illinois, these recommendations were included at the urging of the Chiropractic Health Care Section, in collaboration with policy authors from Public Health Nursing Section. In the policy, the APHA “urges public health and public policy education programs to prioritize and implement evidence based community and provider training programs on mental health, non-pharmacological pain treatment alternatives, substance abuse and overdose prevention”. A second resolution “urges pain prescription providers to be educated on identifying, and treating pain with alternative modalities, and to coordinate pain management with complementary and integrative care providers”.

“The Public Health Nursing section advanced important policy to stem opioid abuse through recommendations to prescribers and public education campaigns,” notes Michele Maiers, DC, MPH, PhD, who led these efforts. “They welcomed suggestions made by the Chiropractic Health Care section to include greater collaboration of care giving with complementary and integrative providers. This policy supports team-based care that gives patients more options when choosing a pain management strategy.”

The benefit of non-pharmacologic therapies has recently been noted by the Joint Commission in their 2015 revision of pain management standards (2014 Update 2, Comprehensive Accreditation Manuals, effective January 1, 2015). Non-pharmacologic therapies are recommended as frontline treatment options for pain management, including acupuncture, chiropractic, osteopathy, massage, relaxation, cognitive behavioral, and physical therapies. The new Joint Commission standards advise organizations that recommend the use of medications to weigh potential benefits to the patient against risks of dependency, addiction, and abuse. This signals a change in best practices for pain assessment and treatment, and recognizes of the value complementary and integrative health care brings to the care of pain patients.


RAND Seeks DCs to Participate in NCCIH Study on Chronic Low-Back, Neck Pain

RAND is seeking chiropractic clinics to participate in a National Center for Complementary and Integrative Health (NCCIH) study that will examine the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low-back and chronic neck pain. Researchers wish to speak with chiropractic clinics in and around Minneapolis, MN, in addition to Dallas, Texas; San Diego, Calif.; White Plains/Yonkers, N.Y.; Portland, Ore.; and Tampa, Fla. Learn more here, and consider this unique opportunity to contribute to research as a practicing clinician.

Call To Action

Bill to Expand Acupuncture Access to Servicemembers, Veterans, and Seniors

Rep. Judy Chu (CA-27) introduced H.R.3849, the Acupuncture for Heroes and Seniors Act. This bill would entitle members of the uniformed services access to acupuncturist services without referral, and require acupuncture services to be offered to all veterans. The bill also ensures that seniors would have access to acupuncture services through Medicare. Finally, the bill would make acupuncturists eligible for appointments as Commissioned Officers in the Armed Forces and in the Public Health Service Commissioned Corps.

The bill language can be found here. A section-by-section summary can be found here. This proposed legislation is in very early stages of gathering support. Contact your representative to raise awareness about this bill and your opinion of it. Click here to find your congressional district and member of Congress.

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Center for Healthcare Innovation and Policy

Michele Maiers, DC, MPH, PhD
Executive Director of Research and Innovation