Sunday, August 8, 2010

Senator Kent Conrad Responds

The following is a letter I received Saturday from Senator Conrad on the issue of the health care reform act paying for CAM. I think it is pretty good and answers some questions other than just for political expediency.

Thank you for contacting me to share your concern that the new health reform law supports complementary and alternative medicine (CAM). It was good to hear from you.

First, you mentioned your concern about a grant program that will fund the development of community health teams to support the patient-centered medical home. As you probably know, evidence suggests that medical homes can improve patients' access to care, improve health care outcomes, and result in lower costs. Patient centered medical homes are built on coordinated networks of providers that facilitate whole person care with an emphasis on primary and preventative care.

The final health reform law cites variety of health professionals who may be eligible to participate in the new health teams, including specialists, nurses, pharmacists, nutritionists, social workers, behavioral and mental health providers, doctors of chiropractic and other licensed complementary and alternative medicine practitioners. However, the Secretary of Health and Human Services (HHS) will make the final decision regarding which practitioners will be eligible to participate in this program.

Next, you shared your concern about a demonstration project that will provide at risk populations who utilize community health centers a personalized wellness program designed to reduce the prevalence of risk factors that can lead to chronic conditions. Wellness plans may include nutrition counseling, physical activity plan, smoking cessation services, stress management, and certain dietary supplements that have proven health benefits. It does not explicitly provide funding for herbalists, as you suggested.

Additionally, you mentioned your concerns about the National Health Care Workforce Commission. This Commission is tasked with evaluating our projected national health care workforce needs. It will not provide funding for any health care discipline. Instead the Commission will provide comprehensive and unbiased information to Congress regarding the growing health care needs of our nation. Decisions on which health care training and development programs should be funded will continue to be made by Congress.

Finally, I shared your concern about the provider non-discrimination policy included in health reform. This provision prohibits insurers form discriminating against any health provider acting within the scope of that provider's license or certification under applicable state law. If you concerns regarding which practitioners are licensed in North Dakota, I encourage you to contact your local lawmakers at 1-888-NDLEGIS (1-888-635-3447) or online at

More broadly, I share your support for utilizing evidence based research to ensure patients are receiving the most effective care. That is why I have been a strong proponent of comparative effectiveness research. One of the best ways to better control health care costs is to provide health care providers and patients with objective and credible evidence about which health care treatments, services, and items are most clinically effective for particular patient populations.

To address the need for this cost saving research, my colleague, Senator Baucus and I introduced the Patient-Centered Outcomes Research Act of 2009 (S. 1213) on June 9, 2009. This legislation would create a new public-private partnership to carry out this important research.

Similarly, the final health reform bill establishes a private, non-profit research institute to provide clinicians, patients, and the public with this kind of data. This is in addition to the $1.1 billion in funding for comparative effectiveness research provided for in the American Recovery and Reinvestment Act, which became law on February 17, 2009. Access to better evidence about what works best will help patients and health care providers make better-informed decisions about how best to treat particular diseases and conditions, potentially reducing unnecessary or ineffective care.

Again, thank you for contacting me.
Kent Conrad
United States Senate.

Skeptical DoDo

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