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Personal Injury
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Personal Injury
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Written by Mark Studin, D.C., F.A.S.B.E.(C), D.A.A.P.M., D.A.A.P.L.M.
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Monday, 25 March 2013 21:56 |
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An in-depth investigative report and analysis prepared for The American Chiropractor Magazine
DISCLAIMER: This treatise is a review and personal opinion on the new Florida No Fault/PIP regulations. You have to make individual clinical and billing decisions on how you want to care and bill your patients. You are strongly urged you to consult all applicable state and federal regulations prior to instituting any treatment or billing strategies. Should you have any questions, please consult either legal counsel or your state organization.
T he change in Florida PIP protection went into effect January 1, 2013, and has significant changes. Many of these changes significantly alter how a chiropractor can treat and get reimbursed. Although there has been much said about the motives behind this legislation and the rhetoric about making changes under the banner of "Fraud Prevention," in the end, the people of the State of Florida will lose, and carriers will increase their profits. There will be no fraud reduction in the new legislation because there are no new provisions to prevent fraud, and there will be no premium reduction in rates to the insured as promised as that was already taken away from the people prior to signing the legislation into law. With that proviso, this article focuses on how to function and thrive within the new legislation.
 Prior to digesting the new legislation and rendering a plan for success, one must understand that this is a huge opportunity for those that position themselves appropriately. The legislation prescribes a blueprint to go well beyond the $10,000 PIP cap if clinically indicated. The new legislation also provides a means for reasonably caring for patients at the usual and customary fees, not subject to 80% of the 200% Medicare fees, and allows for unlimited necessary care without being exposed to independent medical examinations (IMEs) or examinations under oath (EUOs). New Regulation And Benefits Payable
As the new regulations stand now (with the likelihood of any modifications before the start date remote, according to reliable sources), the PIP cap is $2,500 for all providers. The new law has stricken any and all reimbursement for massage therapy or acupuncture. This dollar amount can be expanded to the previous cap of $10,000 should an "emergency medical condition" be determined and certified by a medical physician, physician’s assistant (holds a bachelor's degree), nurse practitioner (holds a master's degree) or dentist. According to Section 9. Section 627-732(16), the emergency medical condition is defined as:
(a) A medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain or other acute symptoms, such that the absence of immediate medical attention could reasonably be expected to result in any of the following:
- Serious jeopardy to the health of a patient, including a pregnant woman or a fetus.
- Serious impairment to bodily functions.
- Serious dysfunction of any bodily organ or part.
This definition ties in with Florida's utilization of a “verbal threshold,” which must be met in order for a third-party tort (worthy of lawsuit) to take place. Understanding the language will help you better position your practice. In states that have a verbal threshold, lawsuits for non-economic injuries are limited to serious injuries or death. “Serious” is defined differently in each state, but it often includes broken bones, severed limbs, etcetera. Unless you meet the defined criteria for a serious injury, you are precluded from bringing a lawsuit against the other driver.
Florida's Verbal Threshold Definition:
- Significant and permanent loss of an important bodily function.
- Permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement.
- Significant and permanent scarring or disfigurement.
- Death.
The significance of the threshold is that patients will have to meet one of these standards to be able to have any success in the legal system and for lawyers to be able to work with your patients. These statutory definitions are the guiding points in how we function under the law.
The $10,000 PIP cap is still in effect and is available to all providers should a patient have an "emergency medical condition" as described above. In order to have those benefits expanded, chiropractors must refer patients to one of the approved providers and in their documentation use the phrase "emergency medical condition" or be subject to the carriers' definition of what “serious” means. The statute is so vague that it leaves the entire process open to the interpretation of the carriers.
However, once they go back to their repetitive lifestyles, they will gradually feel the pain and try unsuccessfully to receive care (beyond the 14-day rule). A challenge in working with medical specialists will be the timeliness of the referrals, the language in their reports and the guaranteed resultant scrutiny these doctors will certainly be exposed to in the form of much quicker and more frequent EUOs and IMEs. In addition, too many patients will be exposed to unnecessary drugs and surgery as you cannot expect the medical specialists not to practice medicine as they deem proper.
Should you get the requisite emergency medical condition documentation, you will be able to care for the patient with a $10,000 cap.
Another very significant law change is the reporting time. Previously, an accident victim had two years to report injuries. The new law allows only two weeks (14 days). This is significant as many accident victims who are less savvy might try to work through their pain or not have significant pain initially. However, once they go back to their repetitive lifestyles, they will gradually feel the pain and try unsuccessfully to receive care (beyond the 14-day rule). This is a significant issue as more than 20% of my accident patients over the last 31 years have waited three to four weeks until instituting care, which is common for the mild to moderate bodily injury victims. Should these patients not have gotten care, they would have serious joint issues over time only to become a burden to the private health insurer, Medicare and/or disability carriers.
Fees
The fees can be confusing because the statute has reimbursement regulations in two sections. In Section 627.736 (1)(a) it states that fees are reimbursable at 80% of all usual and customary. In Section 627-736(5)(f) it states that fees are reimbursable "for all other medical services, supplies and care, 200% of the allowable amount." (I) The participating physicians fee schedule Medicare Part B. The complete rule is that the carriers are required to pay 80% of 200% of Medicare. Once practitioners have received payment, it is recommended that they send the carriers a "Pre-PIP Suit Demand" should they pay only part of the fees, as many carriers notoriously pay less than billed.
Working In And Out Of The Florida Pip & No Fault Laws
You have options in caring and billing for your patients. The initial $2,500 is on the table without any changes in current billing, referral or documentation protocols. If the patient has any serious medical conditions, you can either take the route previously discussed or you can care for the patient should they have an attorney with a letter of protection (LOP) for any additional care clinically indicated. These patients will be considered valid candidates for legal representation if they have met Florida's Verbal Threshold of Serious Injury as previously described. Should they have met that standard, you can treat as often as clinically indicated.
The LOP is an agreement between you and the lawyer and is different than a lien. Unlike a lien, it is for a specific amount that has been pre-determined, and the lawyer agrees to protect that fee for you in settlement. In the State of Florida, all PIP payments must be repaid to the carriers in a lawsuit by the lawyers before any disbursements. Therefore, if the PIP coverage was $10,000 and paid to all providers, then the lawyer cannot earn $1 unless that $10,000 has been repaid first, and the lawyer must be awarded a settlement over $10,000 or they earn nothing. Therefore, if you treat over the $2,500 PIP cap, then the additional fees can be done under an LOP or private health insurance. This gives the lawyers a little more room to work and allows you to treat the patients by rendering only necessary care, avoiding the medical specialists whose care will not be indicated beyond the necessity of a letter to treat an emergency medical condition that is often within the chiropractic scope to treat.
Working Entirely Outside Of Florida No Fault/Pip
Should your patient either opt out by delaying care or find themselves beyond the regulatory 14 days mandatory reporting time for PIP coverage, then you can treat entirely outside of the coverage solely with an LOP or private health insurance. Many trial lawyers find this advantageous as both doctors and accident victims are not subject to the mandatory IMEs and EUOs that often give the carriers an unfair advantage in trials.
Although every case is subject to the verbal threshold of serious injury, not having a carrier's involvement during the treatment process gives many trial lawyers an advantage in preparing their cases. Although our focus as providers has nothing to do with the trial process, and we are concerned solely with necessary care, it is important to understand the entire medical-legal process.
LOPs have no cap and no carrier interference with care. In states like Connecticut that only have LOPs, the system offers many benefits to all parties, including carriers. The only downside to doctors is the lag between the treatment and settlement of the case when payment is rendered. However, once you get into a payment cycle, you will have a constant cash flow that potentially has much less stress and can be far more lucrative without fighting for every penny from a carrier determined not to pay your claim in spite of prompt pay laws.
Every paradigm of practicing with the Florida No Fault/PIP has its benefits and its drawbacks. The reality is that most practices will create a mix of situations where you will utilize all of the above scenarios. There are also numerous other factors in being successful in treating personal injury patients. When working with lawyers, at the end of the day, it will not come down to if the lawyer will work with you, but if the lawyer can work with you. Their ability to work with you has nothing to do with fee schedules or reimbursement criteria, but is solely based upon your knowledge base, formal credentials and ability to document.
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Personal Injury
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Written by Jonathan Walker D.C.
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Sunday, 01 April 2012 00:00 |
P icture yourself driving home late one night with your spouse from a concert downtown. Your normal route is under construction, so you have to detour through a part of town that you don’t ever like to be in, but certainly not at this hour. As you lean over to push the lock button on your doors, you realize there are not very many cars on the road at this hour, and your senses go on hyper alert.
 All of sudden you look up and the car to your left swerves in front of you and has come to a complete stop. There’s no time for you to react, and you plow into the back of the vehicle, jolting your head forward.
As the dust settles and your adrenaline is pumping, you can’t think but help to yourself, “It’s like they came out of nowhere!”
This scenario is called a swoop and scoop, and it’s a classic method of fraudulently staging an auto accident. According to insurance companies PR departments and lobbyists this is an all too common scenario, and a source of billions of dollars in wasted resources. Many would argue that these blatantly illegal and fraudulent acts are isolated incidents that are perpetuated by a very small group of individuals, but there are numerous states where legislative battles are being waged based on the premise of saving consumers money by decreasing fraud.
Almost all efforts to make it more difficult for physicians to bill personal injury protection (PIP) insurance are grounded in these so-called “anti-fraud measures”. While fraud and abuse are very real concerns, the problem is that the proposed measures often do very little in actually combatting fraudulent activities. Several states are currently a battleground for major legislative changes that could impact the ability of chiropractors to help car accident victims recover from their injuries.
There are currently 12 states that still have no-fault auto insurance systems. The term “no-fault” refers to the fact that regardless of which driver was determined to have caused the accident both drivers are eligible for personal injury protection benefits through their own respective insurance carriers.
The 12 no-fault states as of this writing are Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania, and Utah. Each state’s laws differ dramatically with respect to the amount of PIP, litigation thresholds, and various other factors.
The concept of no-fault auto insurance was developed over 40 years ago by Robert Keeton and Jeffrey O’Connell, two law school professors who felt it would reduce the amount of wasteful litigation costs and allow policyholders to efficiently receive medical benefits and lost wages after an accident.
The statutory limits of PIP benefits vary widely state to state. New York drivers are eligible for $50,000, while motorists in Utah are required to carry only $3,000 in PIP benefits. In virtually every state where mandatory PIP benefits exist, insurance carriers are working hard to enact legislative changes to eliminate no-fault status or make access to benefits increasingly difficult.
National news has been made recently in Florida with the passage of House Bill 119 which significantly limits the ability of patients to receive access to treatment in the no-fault system. Florida has long been a popular destination for chiropractors, in large part because of the favorable personal injury laws and scope of practice. This bill essentially creates a two tier system of injuries, a fairly similar approach taken by the Canadian province of Ontario. After the crash the patient is eligible for $2500 in benefits that will cover treatment by an MD, DO, DC, PA, ARNP, or dentist. Massage therapy and acupuncture are no longer covered benefits under the new system in Florida.
If the $2500 is exhausted, an MD, DO, PA, or ARNP (notice chiropractors are blatantly discriminated against) must diagnose the patient with an “emergency medical condition” (EMC) so that the patient will be eligible for the remaining $7500 in benefits. In HS 119 an EMC is defined as:
“Acute symptoms of sufficient severity such that the absence of immediate medical attention could reasonably be expected to result in:
- Serious jeopardy to patient health
- Serious impairment of bodily function
- Serious dysfunction of any bodily organ or part”
It is safe to assume that insurance companies will not simply reinstate the patient’s benefits on the written opinion of a medical provider. Determining whether a whiplash injury meets the criteria of an EMC will largely rest on the ability of physicians to provide objective diagnostic evidence of injury such as stress view x rays, Digital Motion X Ray (video fluoroscopy), or thin slice proton density MRI.
Eliminating chiropractic care as a viable option for accident victims will limit patients from treatment that has been shown to be highly effective for the treatment of whiplash.
It is obvious that “soft tissue injury”, as commonly treated by chiropractors following motor vehicle collisions will be a hotly contested issue. The criteria for an EMC is so loosely defined in the law that it will become even more important than in the past to utilize established standards of care and “gold standards”. The good news for patients and providers alike is that the American Medical Association Guides to the Evaluation of Permanent Impairment considers spinal ligament trauma to be a condition that qualifies for all of the criteria outlined in the new Florida law. Additionally, the National Guideline’s Clearinghouse, which falls under the purview of the Department of Health and Human Services has established clear protocols for the diagnosis and treatment of whiplash injuries.
It is quite likely that the insurance carriers will attempt to override the medical provider’s diagnosis of an EMC, so it will become paramount that there is concrete proof of ligament trauma in order to win the disputes. Since very few medical physicians have an appreciation for spinal ligament injuries on the level that chiropractors trained in evaluating motor vehicle collision occupant injuries do, this presents a huge opportunity, which we’ll discuss later.
Unfortunately, Florida is not the only state where battles are being waged over no-fault benefits. The New York State Senate Insurance Committee has held a series of hearings designed to prevent fraud and abuse. At face value this appears to be a very reasonable effort, and likely needed in many cases. Ellen Melchionni, president of the New York Insurance Association said the proposed legislation “contains numerous remedies, including giving insurance carriers adequate time to investigate fraud, encouraging efficient and fair settlement of disputes and creating tougher penalties for fraud.”
While no honest provider would ever want to see an increase in fraud, any provision that increases the amount of time insurance companies have to “investigate fraud” is typically a code word for delaying or denying claims. Carriers have a point system used to red flag a claim as fraudulent, as some of the measures used might alarm you. For example, if multiple patients from a single accident are being treated by the same doctor or have the same attorney, this could be viewed as potentially fraudulent by a carrier. The treatment of young children after a crash is also a potential fraud trigger. There is an absolute need to combat fraudulent activities like staged accidents and billing for services that weren’t rendered, but giving an insurance carrier more latitude to delay paying legitimate claims is not likely one of them.
Minnesota is another state where the auto insurance system is being targeted. No-fault benefits have existed in this state since 1975, and pressure from insurance companies is causing the Minnesota Senate Commerce Committee to consider changes in how claims are processed. According to Bob Johnson, President of the Insurance Federation of Minnesota, “(Some of the cost increases are) due to fraud and abusive and excessive treatment of patients by aggressive providers who know the system is susceptible to being gamed. Being able to apply cost controls to the system will help lower costs to consumers by reigning in providers who treat outside the mainstream of what is considered acceptable care.”
The problem with this statement is that the insurance companies likely have a very different determination of “acceptable care” than many providers. Accepted standards such as the Croft Guidelines can be used to provide a concrete standard of how much treatment is reasonable or necessary, but many insurance carriers will still likely consider this amount of treatment to be “abusive and excessive”.
PIP reform in New Jersey that is currently taking place focuses on the ability of providers to dispute bills with insurers, a process called arbitration. Marshall McKnight, spokesman for the New Jersey Department of Banking and Insurance, says over 58,000 arbitration filings were made and thousands were “frivolous”. In many no-fault states there are similar avenues that doctors can utilize when they believe that a claim is not being handled fairly by the insurer.
Even if you’re like a majority of the chiropractors reading this, and you do not practice in a no-fault state, it is still time to stand up for our profession.
While there are likely a small handful of doctors who abuse this system, placing limits a provider’s ability to dispute an unfair denial is a very slippery slope. In many states these arbitration processes are often the only leverage that exists for physicians to ensure that they treated fairly. If there is a need for reform it needs to take place with reasonable discussions between insurance carriers, providers, and legislators, not with press releases blanketing the news outlets written by insurance lobbyists.
If you currently practice in a no-fault state, it is important that you take action as quickly as possible. Your state association likely has a list of key state legislators involved in the decision making process, as well as a list of talking points to contact them with. Not only should you email your representatives yourself, but encourage your patients to do the same.
If you have a practice Facebook page or Twitter account, leverage the power of social media to spread the word to your patients and community. If the only voice they hear comes from the talking points provided to the local news outlets by the insurance company, it’s easy for them to develop biased and potentially harmful viewpoints. You can even set up an internet connected laptop in your waiting room underneath a sign explaining the need for their involvement, allowing them to easily email key decision makers.
Most importantly, there is massive opportunity that exists in a state of chaos. The chiropractic profession is at a crossroads, and I believe the next few years will go a long way in determining the future of our industry. The blatant attempts by the insurance industry to marginalize chiropractic and spinal ligament injuries can only be combated by making clear, objective documentation of ligament trauma the standard of care. I often use the analogy that these injuries are like “ACL tears in the spine”, but carry much more severe long term consequences.
There is no profession better educated and positioned to establish a position as experts in the field of ligament injury and conservative treatment strategies than chiropractic. This will create chances to educate personal injury attorneys as well as medical providers as to the serious consequences of these injuries, and how they can be properly diagnosed and treated. Now is the time in invest in personal injury training and coaching programs that can provide you with the ammunition to provide rock solid documentation and communicate effectively with attorneys and medical physicians.
Even if you’re like a majority of the chiropractors reading this, and you do not practice in a no-fault state, it is still time to stand up for our profession. As we’ve seen with the scope of practice discrimination in Texas, decisions are not made in a vacuum. When insurance companies develop a strategy to limit the rights of honest physicians in one state, this tactic often spreads nationwide. Contact your state or local association and get a list of key talking points as well as who you can email or call. This is not only the right thing to do for our profession, but it may ultimately help save your practice down the road.
Dr. Jonathan Walker is president of PI Marketing Elite, a company dedicated to helping doctors see more new PI patients. Visit www.pimarketingelite.com or call 904-616-1284 to speak with Dr. Walker directly.
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Personal Injury
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Written by Paul B. Bindell, D.C.
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Wednesday, 11 May 2011 15:54 |
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A uto accidents, falls and other personal injuries happen regularly. In order for your patient to benefit from your care, and for you to get paid,you must have substantial documentation in your SOAP notes that justifies the care you provided. Due to insurance rules and policies, State Board regulations, and Federal legislation, the depth of detail in SOAP notes must be very extensive. And it must be legible and understandable to claims examiners and insurance auditors as well as attorneys. Many SOAP notes that were considered excellent as recently as 2 years ago would be considered mediocre, at best, and inadequate, possibly indicative for fraud with the new standards that have been established. The answer to this bureaucratic nightmare is an Electronic Health Record system. The bottom line is that Electronic Health Record (EHR) systems are critically essential to the long term survival and growth of your practice.
EHR uses a computer instead of pen and paper. It empowers you to produce a dictation quality SOAP note in a matter of seconds, just by pointing and clicking on the necessary items. The result is a SOAP note that is in English with correct grammar and spelling and contains all the points of information required by law, statute, and policy contracts. Keep in mind that, in most states, and under Medicare, the SOAP note is supposed to be created at the time you are providing the service to the patient, not at a later time. EHR minimizes the time you must spend documenting, so you can concentrate more on patients.
 How does this help your practice? A complete EHR system streamlines your practice in many ways, leading to increased income, higher patient visit averages, and greater productivity by your staff. A patient, signed in at the front desk, automatically appears on the doctor’s computer in the adjusting/treatment area. Entering a diagnosis in the documentation end of the EHR instantly places it in the billing area. The services the doctor documents generate the charges for the day as the patient checks out. Since the EHR system is producing the charges based on the SOAP note, the documentation and billing always match. When the patient signs out electronically, the patient’s signature shows that the patient witnessed that the services billed have been provided and that the patient is ultimately responsible for the charges. This provides both audit and collection protection for you.
And, in a personal injury case, you will need narrative reports for attorneys and insurance. EHR systems produce narratives in seconds, pulling the information directly out of the patient file. Thirty-five years ago, when I first began my practice, narrative production was a major challenge, sometimes taking hours to compile all the material. Now, from the time I receive the request, produce the report and send it to the attorney (either fax, e-mail, or printed and stuffed in an envelope) takes 5 minutes or less. EHR systems typically come with narrative templates already built in. Some EHR systems provide you access to the templates, so you can edit and modify them or create your own. Since you get paid for the narrative, and it is the narrative that will make or break the case for you and your patient, it is critical that the narrative provides the substance that enables the attorney to win the case.
Many doctors, when they get busy, will postpone the completion of a SOAP note until a later time.
Many doctors, when they get busy, will postpone the completion of a SOAP note until a later time. For some doctors, “later” never happens. The result is that the note is not produced, even though charges were entered for the patient. If you are one of those “later” doctors, you must now get caught up on your notes ASAP. In order to be sure the SOAP notes are completed, it is imperative to have an EHR system that generates a report listing every patient that has charges but no SOAP note for that specific date of service. This report should be run at least once daily so that the notes are created in a timely manner, while the information is still fresh in your mind. It is important to note that certified EHR systems include an audit log required by the federal government. The audit log tracks every entry, modification and deletion. In the future, when you are using certified software, an auditor or claims examiner will demand to see the audit log. If your notes were created weeks or months after the visit, they will know and charge you with fraud.
When you use EHR as it was designed, it improves the efficiency of you and your staff, eliminates duplicate entries, minimizes the chance of human errors, and increases your income and patient visit average. EHR gives the attorneys the meat and potatoes to win PI cases, and this builds your reputation and practice. The benefits of EHR are available today. Take advantage of them.
Dr. Paul Bindell is a 1975 graduate of Palmer College of Chiropractic, in practice in Rockaway, NJ, since 1976. Dr. Bindell is a past Chairman of Public Relations for the Northern (NJ) Counties Chiropractic Society. In 1991, Dr. Bindell and his family began Life Systems Software so that the profession would have reliable computer programs based on real chiropractic practice. Dr. Bindell is available to speak to your group or organization and can be reached by email at
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
, or you can call Life Systems Software at 1-800-543-3001.
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Personal Injury
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Written by Mark Studin, D.C., F.A.S.B.E.(C), D.A.A.P.M., D.A.A.P.L.M.
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Monday, 21 February 2011 13:24 |
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W hy is a life in Tennessee, South Dakota and Texas worth more than a life in Hawaii and New York? There is really no reason other than the insurance companies and state politici ans that you have elected into office allow it to be. We are a country of laws and regulations and it is these laws that dictate the marketplace and how doctors are reimbursed for their services. In most states, it is based upon the usual and customary fees of the doctors, the carriers paying a percentage of those fees. However, in other states, like New York, the state sets the doctors’ fees and they are driven by politics at their ugliest.
 The collections listed in the following table depict what chiropractors are collecting in their offices as of November 2010, on a per-visit basis for a typical treatment. The numbers exclude examinations, X-rays, supports and any other ancillary services or testing. The sampling taken, although not 100% accurate for a statistician, is an accurate representation of what doctors are collecting today.
Logically, one would think that the higher the cost of living, the higher the level of reimbursement. That is not the case. In fact, New York and Hawaii are two of the most expensive states to live in, yet have the lowest levels of reimbursement nationally. New York, which, in spite of its ranking 46th with regards to cost of living, undoubtedly a result of its vast rural areas, pushes it out of the highest ranking. A 500 square foot office in downtown New York City can cost $7,000 per month to rent, yet the maximum reimbursement a chiropractor can receive is $33.70 per visit and has been so for 16 years, no matter what services the doctor provides. In addition, the carrier sends for an IME after a few visits in order to limit the amount of care, further reducing the doctor's ability to receive fair and equitable reimbursement.
By law, the State of New York sets a doctor’s personal injury (no-fault) fees, as they are tied into the workers compensation fee schedule. After a 16 year absence of any fee increase, chiropractors in New York were just given a pay raise to $46.24 per visit. Over the last 16 years, while chiropractors were reimbursed at $33.70, physical therapists were reimbursed $61.60 and medical doctors were reimbursed $67.60 for the same services by CPT code. The new fee schedule in New York was created without a chiropractor being able to contribute to the political process, yet the American College of Occupational Medicine and large labor unions in New York played major roles in shaping the future of chiropractic in New York.
As a result of the low fee schedules in New York, doctors of chiropractic are emigrating and relocating to other states. Considering that the average chiropractic case, according to Chiropractic Lifecare of America (2009), is $3,799, while the average non-surgical hospital stay is $15,059, spinal surgery averages $77,107 without complications and ranges from $117,901 to $260,584 with complications, not including any doctors’ fees, according to Virginia Healthcare and Hospital Association (2010). For every chiropractor that emigrates in any state, the cost of healthcare is rising.
In addition, a 2004 study by Legorreta, Metz, Nelson, Ray, Chernicoff, and DiNubile compared more than 1.7 million insured patients seeking treatment for back pain. The outcomes showed, when chiropractic care was utilized in comparison to the standard medical approach, the cost of treatment was reduced by 28%, hospitalizations were reduced by 41%, back surgery was reduced by 32%, and the cost of medical imaging, including X-rays and MRI’s, was reduced by 37%. Furthermore, 95% of the patients that received chiropractic care reported in the study that they were satisfied with their treatment. Utilizing chiropractic care as the first treatment option for back pain was estimated to have the potential to reduce US healthcare costs by more than $28 billion annually.
Fair and equitable reimbursements for any provider will determine if a doctor can afford to live in any community nationally, and wise legislators will take into account the above statistics, so as not to be "penny wise and dollar foolish," unlike those elected officials in New York. There are solutions to ensure that this scenario does not happen in your state, but that is a topic for a future article.
References:
1.American Chiropractic Association. (2010). Back Pain Facts & Statistics. Retrieved from https://www.acatoday.org/level2_css. cfm?T1ID=13&T2ID=68.
2.Chiropractic Lifecare of America. (2009). The MESTAT Project.
Learning. Retrieved from http://www.clahealthcare.com/ learning/ index.html.
3.Russo, A., Wier, L. M., & Elixhauser, A. (2009, September). Hospital utilization among near-elderly adults, ages 55 to 64 years, 2007.
Agency for Healthcare Research and Quality. Retrieved from
http://www.hcup-us.ahrq.gov/reports/statbriefs/sb79.jsp.
4.Legorreta, A. P.; Metz, R. D.; Nelson, C. F.; Ray, S.; Chernicoff, H. O.; & DiNubile, N. A. (2004). Comparative analysis of individuals with and without chiropractic coverage: Patient characteristics, utilization, and costs. Archives of Internal Medicine, 164(18),1985-1992.
5.CNBC. (2010). Cost of Living – 2008. Retrieved from
http://www.cnbc.com/id/25501974/.
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