ACA's Gary Cuneo organized a conference call with the EVP Advisory Committee
regarding the Workers Compensation crisis that our profession is currently
facing. Our crisis is the increasing exclusion of chiropractic from workers
compensation across the nation. Doctors from various states participated in
discussing issues pertinent to their particular states.
There have recently been studies sponsored by the insurance and business community showing chiropractic utilization in the workers compensation system significantly increases the cost of treatment, calling it a "key cost driver." These studies sponsored by insurance interests are being used to promote anti-chiropractic workers compensation reform in various states. These studies are based on utilization data submitted by the insurance companies and are interpreted to bias against chiropractic utilization.
Dr. Dale White of Texas said their association saw bills being proposed in their Legislature that would severely limit DC participation in Work Comp and the Texas DCs decided to sponsor their own study. Through a political contact, they were able to obtain utilization records from their State Workers Compensation Administration. They hired a research firm that is well recognized and asked the firm to do a utilization study of chiropractic in the Texas Workers Compensation system. The study found that those injured workers that saw a DC as the entry point treating physician saved the payer more than 50% of the cost generated by those injured workers that saw an MD as the entry point physician. Additionally, this study did not include the cost of prescribed drugs as drug expenditures were not tracked by the Texas WC Administration. If prescribed drugs were factored in, cost savings with chiropractic utilization would be even greater. It was pointed out by Dr. White that the great discrepancy between the conclusions of the insurance sponsored studies and the Texas chiropractic sponsored study was due to the insurance studies having separated costs for treatment generated when an MD was the entry point, such as the cost of physical therapy, drug therapy, etc. If those costs generated when an MD is entry point are added up, they amount to more than twice the costs that are generated when a DC is the entry point for the injured worker.
The Texas DCs had a 6 panel color brochure made summarizing the results of the study and used the brochure to lobby their Legislators. Their Legislative Session is not over until May and so the outcome for the Texas DCs is still pending.
A short review of the findings of this study can be seen in the Dynamic Chiropractor, April issue, titled "Ground Breaking Chiropractic/Workers Compensation Report Published."
The Florida DCs were squeezed out of the Workers Compensation System in 1997 when managed care for injured workers was mandated by the Legislature. This occurred because special interests convinced their state Legislators that DCs were the main group driving up the cost of workers compensation in Florida. A year or so ago they hired the same company as the Texans, MGT, to do a utilization study for them and the results were similar to those in Texas. The Florida DCs took this information to their Legislators with a good result. DCs can now be managed care coordinators in the Florida WC System. The Florida study is published on the website at MGTofamerica.org. The Texas study is not yet public but will be on the same website by the end of May.
Some other states have current favorable WC legislation. For instance, in the Kentucky Work Comp Managed Care System, workers may choose their provider and there must be one DC for every six medical providers on the panels in urban areas.
Tony Rosner of FCER spoke of his testimony before the Pennsylvania Legislature countering the arguments in the Workers' Compensation Research Institute report that were very critical on chiropractic. His testimony and a synopsis of the ACA's cost effectiveness of chiropractic treatment are available from ACA.
Here in New Mexico, we currently have legislation that is limiting injured workers access to our offices. That legislation is the 60 day rule. The rule mandates that the company where the injured worker is employed has the first choice of provider. We all know what the result of that has been. If we can approach our community, employers and legislators with this overwhelming evidence of our cost effectiveness, we may change the tide here also.