Billing / Fees / Insurance

Practice Models for the 21st Century: An Interview With Michael McCoy

Kristen E. Porter, PhD, MS, MAc, LAc; Elizabeth Sommers, PhD, MPH, LAc

Shifting the paradigm of private practice, new models of practice and service delivery are continually being developed and evaluated by the acupuncture community. In this month's column, we interview Michael McCoy, executive director of the AOM Alliance.

Kristen Porter (KP)/Beth Sommers (BS): The AOM Alliance is spearheading a new Community Acupuncture Network. Can you tell us about the idea behind this network and its mission?

Michael McCoy (MM): Community acupuncture, by definition, creates an increase in access to acupuncture by sharing information and resources among community acupuncture practices. Community acupuncture practice refers to clinics that may have one or more practitioners who treat folks in a community setting, meaning more than one person in a room at a time. These practices operate with a sliding scale fee structure to make acupuncture accessible to people with limited resources.

KP/BS: The concept of community acupuncture is not new; many U.S. clinics have been operating in this format for a long time. In your opinion, why is our profession now embracing community acupuncture with such vigor?

MM: There has been an increase in the popularity of acupuncture in all levels of society, and it is rapidly moving from the margins into the mainstream. Community acupuncture is one approach of delivering acupuncture that provides resources to individuals who may not have disposable income or health insurance. It reaches out to groups who tend to be under-served by all sectors of the health care system. As acupuncture penetrates the mainstream, there is a growing need for this kind of practice. Almost one quarter of Americans have no access to health insurance; so even with insurance reimbursement, there is limited access to acupuncture. And these are folks who can probably benefit from acupuncture.

KP/BS: What is contributing to acupuncture's flow into the mainstream?

MM: The promotional work of acupuncturists and the national organizations to bring acupuncture to the media and to the community. There is a growing maturity to the profession, and we are in a stage in the life cycle where we are going to see a willing acceptance of acupuncture. Therefore, this is the time to be more energetic in our promotion.

Secondly, the rise of acupuncture is occurring concurrently with a health care crisis in America. Western health care is pricing people out. Acupuncture can be more cost effective and piquing the interest of people with less disposable income.

KP/BS: The National Acupuncture Detox Association (NADA) has used group treatment for more than 30 years in addressing issues of chemical dependency and mental health. Do you feel NADA has contributed to a professional environment/sentiment that supports this type of treatment?

MM: NADA is very supportive of the community acupuncture movement. While I am not a practitioner, I am a devoted patient, and I have been treated in group settings and individual settings, and these are two uniquely different ways of receiving treatment. There is a real power in group treatment that cannot be beaten. NADA has helped create an awareness of this power.

KP/BS: I understand you are still in the planning stages, but tell us how you envision the structure of the Community Acupuncture Network?

MM: Membership will be based on similar principles of a community acupuncture practice. Fees will be on a sliding scale. The network will offer an information clearing-house for resources, ideas, and conversations. The Web site will offer discussion boards, means to exchange ideas, and practical information to help people who want to try this practice format. For example, we'd like to highlight models of care that people are using and offer a forum on the Web site for discussion and interchange.

KP/BS: There has been a lot of favorable response to information presented about community acupuncture. What is the biggest criticism you are hearing and what is your response?

MM: The concern we hear is that if you provide sliding scale or lower rates, it prevents other practitioners from being able to charge full price. I don't think that's the case. There is a lot of room for people to price services differently. The best argument is to point to what actually happens in community acupuncture practices. New segments of the population are being brought in, patients who would not otherwise be able to access care. In one community acupuncture practice, there are 2,000 active patients, with two-thirds resulting from patient referrals. Networks like this help bring in new patients through education and promote all practices. It also helps meet the increased demand.

Not all patients will like the group treatment concept and they can be referred to private offices. In the long term, I believe this may become an important paradigm for other types of CAM approaches. We are going to see profound shifts in health care delivery in America and this may drive the profession forward.

KP/BS: Any type of community process succeeds with collaboration. How do you see this movement in building new collaborations?

MM: Patients are taking more responsibility for their own health. Patients want to buy in at another level besides just being patients. All kinds of collaborations can develop from community acupuncture. For example, one program has partnered with community gardeners to provide local produce for their patients.

KP/BS: Why did the AOM Alliance get involved?

MM: The AOM Alliance has a long-standing interest in diversity, and so we were well primed to understand and support a good idea. The Alliance can provide some infrastructure support, and I am working personally on the project because I believe in it.

KP/BS: What's your long-range vision for the network?

MM: As economic resources are generated down the road, we hope to be able to provide support to practitioners who would like to transition to this model by offering startup grants. We think the model is economically viable, but we also understand that transitional time is needed for individual providers.

KP/BS: How can people get involved?

MM: People can join the mailing list by sending an email to: director@aomalliance.org.

KP/BS: Thank you.

For more information on the AOM Alliance, visit www.aomalliance.org. For classes and internship programs in group treatment format, visit www.pathwaysboston.org or www.workingclassacupuncture.org.

October 2006
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