Coverage Issues --NIH/AHCPR 1996

In early 1996, Wayne Jonas, MD, then director of the NIH Office of Alternative Medicine, chose to explore the coverage issues begged by the growing CAM interest. He linked with his counterpart at the Agency for Healthcare Research and Quality (then the Agency for Health Care Policy and Research), and the new Program in Integrative Medicine at the University of Arizona, for a one-pay intensive meeting of about 20 private, academic and public sector people on the subject. I was asked to present one of the three papers. Because I was deeply involved in the work in Washington state to include “every category of provider” in health plans, I was able to turn a theoretical piece into a treatise with a good deal of detail on the actual experience and the diverse models which were being built by health plans in Washington. My favorite part, however, remains Section 5: Bias as an Obstacle to Integration. 56 pages, 222kb

Introduction: “Matchmaker, Matchmaker, Make Me a Match ...”

A sobering perspective on the operational issues in integrating complementary medicine into the reimbursement system unites two unflattering characterizations of the parties which are being coupled. A proponent of complementary medicine, writing in Britain’s Complementary Therapies in Medicine, argues that “the coming of age of complementary medicine raises questions that an informal, fragmented and fringe movement has not so far addressed.” In a recent issue of Health Affairs, Harvard Medical School associate professor of medicine and health care policy David Blumenthal suggests that, for many health care professionals, following changes in the healthcare system as documented in the Wall Street Journal is to “watch a train wreck in slow motion.”

In this unfriendly light, our key operational question becomes: How do we board chaos onto catastrophe? 

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