do those with insurance for chiropractic care. Payers should scrutinize the fact that our 2017 survey with Gallup found that 60 percent of chiropractic patients in the past year had coverage for chiropractic care, with 46 percent of them reporting that insurance paid for only some of their chiropractic care. Patients’ primary reasons for their out-of-pocket expenses were the use of out-of-network doctors and unmet deductibles.12


In response to a wave of new research about chiropractic care that endorses its benefits, some insurers and payers are working to remove barriers for policyholders. For example, UnitedHealthcare in July 2019 started offering employers in some states a benefit for policyholders with acute low-back pain that makes it more affordable to access physical therapy and chiropractic care. It plans to expand the benefit to employers with self-funded plans and in more markets through 2021.


Insurance Awareness WHAT CAN HEALTH PLANS DO?


For many companies, musculoskeletal complaints are the No.1 reason employees go to a health-care provider.8


Clinical


studies have shown spinal pain regularly co-exists in patients with other physical and mental illnesses.9


Health plans, from Medicaid to Medicare to private-sector insurers, usually cover physical and occupational therapy and chiropractic care for chronic pain, but a recent medical research study found that visit limits and prior authorization restrictions by the insurers are common. Lack of consistent insurance coverage and management of patient use by payers underscores the need to improve payment for management of chronic, non-cancer low-back pain when it’s such a widespread condition.10


Chiropractic care safely reduces patients’ pain and health-care costs. “The average cost of a low-back injury claim in the U.S. is $15,884. When a worker with such an injury receives at least 75 percent of care from a chiropractor, the claim cost decreases to $12,202 and when the worker receives at least 90 percent of care from a chiropractor, the average cost declines even further to $7,632.”11


In the same vein, research with American adults shows that chiropractic patients without insurance for this type of care pay nearly twice as much for a typical chiropractic appointment as


Number of Spinal


Imaging Tests


22% decrease


Number of Spinal Surgeries


Forecasted Impact of Chiropractic Benefits Trough 2021


21% decrease


Opioid Usage


19% decrease


02 PALMER COLLEGE OF CHIROPRACTIC


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