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Shore Health Integrative Medicine Center Founder David Mercier on Acupuncturists and Medicare PDF Print E-mail
Written by John Weeks   

Author and Shore Health Integrative Center Founder David Mercier, LAc: What Would it Mean if Licensed Acupuncturists Were in Medicare?

Include licensed acupuncturists?
In February 2013, the licensed acupuncturists in the United States successfully generated 27,769+ signatures on a petition to the White House. The Integrator joined organizations such as the American Association of Acupuncture and Oriental Medicine and the National Certification Commission on Acupuncture and Oriental Medicine in efforts to get out the vote. The goal: include their discipline as healthcare providers under the Social Security Act, thus creating access to Medicare reimbursement.

At the 11th hour, on February 10, 2013, the number squeezed over the 25,000 threshold to guarantee that someone in the Obama administration would think about the potential value of bringing acupuncturists into the fold for at least a minute.

David Mercier, LAc
The petition campaign and the Integrator promotion via an alert were not unanimously supported. Some of the oppositional views were included in the Policy section of the February 2013 Round-up. A subsequent submission arrived from author and former
hospital system-based integrative health leader David Mercier, LAc. Mercier may be the one licensed acupuncturists in the US who was trusted by his health system to lead a significant integrative health initiative. (See Shore Health System: Exploring CAM-IM's Economic Value in Nurse Retention and Shore Health's Awarded Reiki Program: Strategy and Outcomes.) More recently, Mercier wrote a powerful, inspiring and award-winning book on integrative health entitled A Beautiful Medicine: A Radical Look at the Essence of Health and Healing, some of which is available online here.

Here are Mercier's comments, originally sent a a personal note. I asked if he might publish and he tweaked what he had written and sent this back. He poses a very basic question.


Medicare Coverage for Acupuncturists: Who Has Projected the Actual Meaning to the Profession?

"Thanks for the latest information on this petition to have acupuncture included in Medicare. As a step forward for this country and its healthcare quagmire, I think it's incredibly important and has many significant ramifications for the future of acupuncture and integrative medicine in this country. Many hospitals reimburse for only those services reimbursed by Medicare, so this would open the doors in many areas.

"My question about this has to do with the real-life scenarios that the acupuncture community is hoping to achieve with this.  Conceptually, for the reason I mentioned above, I think it's terrific. Millions of elderly patients would have access to treatment, and the status of reimbursement for acupuncture would be transformed.

A Beautiful Medicine: Mercier's recent. radical treatise
"On the other hand, virtually all of my many physician friends have been telling me for decades about their disgust with Medicare because of the complexity of the paperwork and the very low reimbursement rates. Many of them are opting out of Medicare entirely, and some are going into boutique practices to simplify their practices, to heal their Medicare headache. Many family practitioners have had trouble staying afloat financially, partly because its of low reimbursement rates.

"Has anyone done a projection as to what sorts of work, time, and reimbursement an acupuncturist might expect to encounter?  For me, it's an interesting juxtaposition of doing the right thing for patients with the willingness to take on the extra complexity that comes with being a Medicare provider.  If acupuncturists end up putting a lot of extra time into getting reimbursed at much lower rates than they're accustomed to, I'm wondering if their participation in Medicare might be limited. In my case, I'm not a participating provider with the regular insurance companies.

"I'm interested in knowing if any projections have been created for the way this will impact acupuncturists' practices and for what percentage of acupuncturists will become Medicare providers.  I believe that for larger or institutional practices with billing departments, the issue will be less of a concern than for those in solo or small group practices."

Comment: As a non-practitioner, I don't have skin in the daily dirty business of third-party payment. I needn't touch the bundled mess of codes, under-payment, paper trails, white lies, phone hassles and time burdens. Nor is my daily worked disturbed by mounting passive aggression against the patient in front of one who I know can definitely benefit from additional time or services that will not be reimbursed. All of this will flow from Medicare inclusion.

Long-time i
ntegrative medicine clinician and radio host Ronald Hoffman, MD has more than once taken me on, accusing me of naivete here and elsewhere. Yes, I sent the Integrator support for the Petition out of a view that the campaign was, in Mercier's phrase, "conceptually terrific." As I shared in my comments to Hoffman's response, my operating concept is to give those outside the system the choice. Hoffman
and his medical doctor colleagues have the choice. No acupuncturist will need to accept Medicare.

The value of inclusion of acupuncturists and others now outside the system is that some will say yes, and scores of thousands will gain access. Meantime, the profession will find itself side-by-side with the others in the primary care and outpatient services arena, pulling at oars, underfed, in the rancid galleys of U.S. medical payment and delivery. This ugly image fuels a dream that they will jointly rise up against the slave wages to community practitioner via Medicare as guided by the AMA's specialist-dominated RUC Committee that guarantees that those doctors who prefer to play with knives and machines than talk to people get paid more for each minute of their time.

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