Health Care Reform

This section was compiled by Frank M. Painter, D.C.
Send all comments or additions to:   Frankp@chiro.org

Health Care Reform Articles

	A Health Care System in Transformation: Making the Case for Chiropractic Chiropractic & Manual Therapies 2012 (Dec 6); 20 (1): 37 ~ FULL TEXT There are a number of factors that have conspired to create a crisis in healthcare. In part, the successes of medical science and technologies have been to blame, for they have led to survival where lives would previously have been cut short. An informed public, aware of these technological advances, is demanding access to the best that healthcare has to offer. At the same time the burden of chronic disease in an increasing elderly population has created a marked growth in the need for long term care. Current estimates for expenditure predict a rapid escalation of healthcare costs as a proportion of the GDP of developed nations, yet at the same time a global economic crisis has necessitated dramatic cuts in health budgets. This unsustainable position has led to calls for an urgent transformation in healthcare systems. This commentary explores the present day healthcare crisis and looks at the opportunities for chiropractors as pressure intensifies on politicians and leaders in healthcare to seek innovative solutions to a failing model. Amidst these opportunities, it questions whether the chiropractic profession is ready to accept the challenges that integration into mainstream healthcare will bring and identifies both pathways and potential obstacles to acceptance.
	Improving Our Nation's Health Care System: Inclusion of Chiropractic in Patient-Centered Medical Homes and Accountable Care Organizations J Chiropractic Humanities 2014 (Dec); 21 (1); 49–64 ~ FULL TEXT This report summarizes the closing plenary session of the Association of Chiropractic Colleges Educational Conference—Research Agenda Conference 2014. The purpose of this session was to examine patient-centered medical homes and accountable care organizations from various speakers’ viewpoints and to discuss how chiropractic could possibly work within, and successfully contribute to, the changing health care environment.
	Healthcare Reform: Implications for Chiropractic ACA News (December 2013) Earlier this year, Daren Anderson, MD, and I discussed healthcare reform, primary care teams and the integration of chiropractic services into the healthcare system as valuable members of the medical team with ACA News readers. [1] Since that time, the government of the United States was shut down for 16 days in an attempt to delay healthcare reform and defund the Affordable Care Act. [2] Yet the Health Insurance Marketplace is open with the task of finding quality health coverage for Americans through private companies. [3] Affordable Care Act funding continues as the law of the land. [4] What follows is information regarding healthcare reform and suggestions for those chiropractic physicians interested in joining the healthcare delivery systems of the 21st century as valuable members of healthcare teams within coordinated care organizations.
	The Coming Changes in Health Care: What DCs Need to Know Health Insights Today (July 2013) Enjoy this Daniel Redwood, D.C. interview of Dr. Gerard Clum. In recent years, Dr. Clum has spoken to numerous employer, insurance and health industry groups on behalf of the Foundation for Chiropractic Progress, providing powerful, fact-based presentations on the positive effects chiropractic inclusion can bring to both new and traditional forms of health care delivery. He is among the most knowledgeable people in the profession on issues related to the Affordable Care Act and the potential for chiropractic participation in the new entities (Patient Centered Medical Homes and Accountable Care Organizations) being developed as part of health reform.

The Affordable Care Act

	AMA on Warpath to Overturn Provider Non-discrimination Provision of the Affordable Care Act ACA Press Release (June 26, 2012) The American Chiropractic Association (ACA) today reaffirmed its commitment to fighting provider discrimination, responding to a recent decision by the American Medical Association’s (AMA) House of Delegates to initiate a lobbying effort against Section 2706, the provider non-discrimination provision in the Patient Protection and Affordable Care Act (PPACA).
	Chiropractic and Health Care Reform: An Uncertain Future or an Opportunity? Dynamic Chiropractic (March 26, 2012) For these and other reasons, the chiropractic profession has much to offer health care reform. However, for the most part, the profession appears to have been marginalized in the health care reform process up to this point in time. It is important for all stakeholders that the chiropractic perspective be represented and that chiropractic leaders and practitioners be participants in health care reform.
	The Chiropractic Identity: Charting Our Future Roles Health Insights Today (September 2011) For at least as long as any living doctor of chiropractic can remember, our profession has engaged in ongoing and sometimes heated debate about the proper role of its practitioners. Should our primary or sole focus be the spine? The nervous system? Vertebral subluxation? Back and neck pain? Should we be musculoskeletal pain specialists? Complementary care generalists? Primary care physicians?   Two new papers, one by Donald Murphy and colleagues in Chiropractic and Manual Therapies [1] and the other by Jan Hartvigsen and colleagues in British Medical Journal, [2] simultaneously point in the same direction—toward the role of primary spine care practitioner.

Reference Section

	Chiropractors As The Spinal Health Care Experts A Chiro.Org article collection Enjoy this collection of articles: It is widely recognized that the dramatic increase in health care costs in the United States has not led to a corresponding improvement in the health care experience of patients or the clinical outcomes of medical care. In no area of medicine is this more true than in the area of spine related disorders (SRDs). Costs of medical care for SRDs have skyrocketed in recent years. Despite this, there is no evidence of improvement in the quality of this care. In fact, disability related to SRDs is on the rise. We argue that one of the key solutions to this is for the health care system to have a group of practitioners who are trained to function as primary care practitioners for the spine. We explain the reasons we think a primary spine care practitioner would be beneficial to patients, the health care system and society, some of the obstacles that will need to be overcome in establishing a primary spine care specialty and the ways in which these obstacles can be overcome.
	The Biopsychosocial Model A Chiro.Org article collection The late George Engel believed that to understand and respond adequately to patients’ suffering — and to give them a sense of being understood — clinicians must attend simultaneously to the biological, psychological, and social dimensions of illness. He offered a holistic alternative to the prevailing biomedical model that had dominated industrialized societies since the mid-20th century. [1] His new model came to be known as the biopsychosocial model.
	“Best Practices” in Chiropractic A Chiro.Org article collection Explore the shift from Guidelines, often containing numbers/ suggested treatment time frames, to “Best Practices”, which are clinical decisions informed by the best evidence available, and balanced by patient complexity and provider experience.
	A Clinical Model for the Diagnosis and Management of Patients with Spinal Pain Syndromes A Chiro.Org article collection This collection of articles discusses the shift away from the classical focus on musculoskeletal diagnosis to drive care, to a a more balanced focus on patient response to care.

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