Accountable care organizations (ACO) could include complementary and alternative medicine (CAM).

The Integrator Blog reports on ACO inclusion of CAM’s 180,000-strong workforce:

NCCAM-funded team examines possible roles of complementary practitioners in Accountable Care Organizations

A team of NCCAM-funded health services researchers recently published a substantive editorial in the Journal of Alternative and Complementary and Medicine entitled CAM Practitioners and Accountable Care Organizations (ACO): The Train is Leaving the Station.  The authors, led by Mathew Davis, DC, MPH and sometimes Integrator-contributor James Wheedon, DC, take the position that "this is a critical time for the U.S. health care system and an important time for CAM professions to consider how they might fit into an ACO era." The writers estimate that the "relatively large CAM workforce" amounts to roughly 180,000 licensed CAM practitioners. These will assume one of 3 positions in ACOs: exclusion, partial inclusion or "full participation." The latter would include meaningful roles in incentive payments via ACA "shared savings" programs. The writers propose areas of potential cost savings from CAM inclusion, noting that the pain-related services with which CAM practitioners are frequently involved make up a good deal of conventional primary care. Ultimately, the authors call for collaboration among CAM professions:

"As policymakers, payers, and stakeholders come together to discuss ACOs, the authors believe CAM professions will have a louder voice as one large group. There are a diverse number of professional organizations both within and across CAM professions that united could influence adoption of CAM into national health care reform efforts such as ACOs. Conversely, should CAM professional organizations continue to act individually, increased competition between CAM professions."

Comment: The Affordable Care Act in Section 5101 states that health care workforce plans shall include licensed CAM disciplines. However, Section 3502 on patient-centered medical homes was less assertive. The teams in these homes, according to Congress’ language, "may" include chiropractors and members of other licensed CAM disciplines. Credit this team for bringing this issue of how these practitioners "may" be used to the fore. I like and agree with their call for united action. Multidisciplinary vessel for such collaborative work that are noted in the article include the Integrated Healthcare Policy Consortium and the Academic Consortium for Complementary and Alternative Health Care. The authors conclude with a note of urgency: " … should CAM practitioners and professions fail to get involved in the discussion now, they may not have the opportunity later."

Thanks to John Weeks for bringing this report to public attention.  He has been at the forefront of bringing CAM issues into public debate for a while.

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Michael H. Cohen


Michael H. Cohen is a thought leader in health care law, pioneering legal strategies and solutions for business law clients in traditional and emerging healthcare. wellness, and lifestyle markets.  Mr. Cohen represents a broad range of healthcare providers and entities, including: medical and osteopathic doctors; physician groups and clinical facilities; integrative medicine centers; psychologists, licensed clinical social workers, registered and advanced practice nurses, physician assistants, dentists and other allied health professionals; complementary and alternative medicine practitioners such as chiropractors, acupuncturists, massage therapists, somatic bodyworkers, energy healers, hypnotherapists and medical intuitives, naturopathic physicians and practitioners of homeopathy; life coaches; dietary supplement manufacturers and distributors; cosmetics manufacturers; HCG and weight loss centers; medical device manufacturers; telemedicine and telehealth business; healthcare educational institutions, health insurance organizations, and medical spas;  and many other enterprises.

As a corporate and regulatory attorney who has also handled litigation matters, Mr. Cohen represents conscious business leaders in a transformational era. Clients seek Mr. Cohen’s specialized expertise on business structure and entity formation (corporations, partnerships, LLCs); credentialing, licensing, and scope of practice concerns; professional disciplinary matters before state medical, psychology, chiropractic, and other boards); employment contracts and independent contractor agreements; dispute resolution; e-commerce; intellectual property issues; informed consent and malpractice liability issues; HIPAA and confidentiality and privacy issues; Stark, self-referral, anti-kickback, patient brokering, and fee-splitting questions; dietary supplement labeling; medical device approval and other FDA matters; insurance reimbursement and Medicare issues; website disclaimers and review of marketing materials; advice on concierge medicine and retail boutique medicine; telemedicine, telepsychiatry and telehealth; and other legal and regulatory advice in the business law and health law arenas.  Mr. Cohen is also highly sought after for special legal counsel by other attorneys and law firms in the areas of complementary/integrative medicine, aesthetic and cosmetic medicine, medical board discipline, medical spa liability, and medical malpractice liability malpractice  (negligence) involving CAM practices or telemedicine, tele-health and online health services.

Mr. Cohen graduated from Columbia University (BA), Boalt Hall School of Law at the University of California, Berkeley (JD); the Haas School of Management at the University of California, Berkeley (MBA); and the Iowa Writers’ Workshop at the University of Iowa (MFA).  In law school, he served as an editor of the California Law Review.  He also attended the Medical Institute for Law Faculty at the Cleveland Clinic. Following law school, he served as judicial clerk for the Honorable Thomas P. Griesa, United States District Judge in the federal Southern District of New York. Mr. Cohen was an associate in the Corporate Department at the Wall Street law firm Davis Polk & Wardwell, focusing on banking, securities law, and mergers & acquisitions. He was on the faculty of several law schools, teaching civil procedure, conflicts of laws, constitutional law, criminal law, health law, and insurance law.  He served as Director of Legal Programs at the Center for Alternative Medicine Research and Education (Beth Israel Deaconess Medical Center), and then the Harvard Medical School Division for Research and Education in Complementary and Integrative Medical Therapies and Harvard Medical School Osher Institute. He was also Assistant Professor of Medicine at Harvard Medical School, with a joint appointment as Assistant Adjunct Professor in the Department of Health Policy and Management at the Harvard School of Public Health. While at Harvard, Mr. Cohen was Principal Investigator on two grants, Legal and Social Barriers to Alternative Therapies (National Library of Medicine at the National Institutes of Health) and Pediatric Use of Complementary Therapies by Parents: Ethical and Policy Choices (Greenwall Foundation), and Co-Investigator on several other funded projects, including Models of Integrative Care in an Academic Health Center. Among his activities, Mr. Cohen pioneered the course, “Complementary and Alternative Medicine: Health Law and Policy” at the Harvard School of Public Health. He also was awarded a Fortieth Anniversary Senior Fellowship at the Center for the Study of World Religions, Harvard Divinity School.

Mr. Cohen has published over 100 articles, and books, including: Creative Writing for Lawyers (Citadel Press, 1990); Complementary and Alternative Medicine: Legal Boundaries and Regulatory Perspectives (Johns Hopkins University Press, 1998); Beyond Complementary Medicine: Legal and Ethical Perspectives on Health Care and Human Evolution (University of Michigan Press, 2000); Future Medicine: Ethical Dilemmas, Regulatory Challenges, and Therapeutic Pathways to Health and Healing in Human Transformation (University of Michigan Press, 2003); Legal Issues in Integrative Medicine (NAF Press, 2005); and Healing at the Borderland of Medicine and Religion (University of North Carolina Press, 2005).

Following a successful academic career, Mr. Cohen returned to the practice of law. In addition to his professional activities, Mr. Cohen received certification as a Registered Yoga Teacher. Whether advising start-ups or established companies, he brings his entrepreneurial spirit and caring insight to cutting-edge legal and regulatory challenges.

Mr. Cohen is admitted to practice in California, Massachusetts New York, and Washington, D.C.  To speak with an experienced business and health care law attorney about your legal concerns, contact our attorneys today.