by Leila Morris
At one time, acupuncture and chiropractic were considered fringe medicine. But the use of complimentary alternative medicine (CAM) has gained growing acceptance among employers and consumers as it has proven to be effective in treating a range of conditions.
An example of this growing acceptance is the nation’s first doctorate program in acupuncture and oriental medicine at the Southern California Univ. of Health Sciences, which recently received regional accreditation from the Western Association of Schools and Colleges.
A study at Rutgers University reveals that electro-acupuncture is effective in treating a potentially deadly and all too common condition – Sepsis. This inflammatory response to infection contributes to half of all hospital deaths, according to the American Thoracic Society. Researchers also find that electro-acupuncture may be effective in treating common inflammatory diseases, such as rheumatoid arthritis, osteoarthritis and Crohn’s disease. “This research shows physical evidence of acupuncture’s value beyond any that has been demonstrated before,” says researcher Luis Ulloa of Rutgers New Jersey Medical School who is quoted in the university publication, Rutgers Today.
A study in the journal of The North American Menopause Society (NAMS) finds that acupuncture can also -alleviate the severity and frequency of hot flashes in natural menopause. This finding is significant since growing numbers of women are opting out of hormone treatment. Also, the National Institutes of Health (NIH) reports that acupuncture is effective in treating persistent pain conditions, including back pain, neck pain, and carpal tunnel syndrome.
The benefits of using acupuncture for pain are not lost on one of the nation’s biggest employers. The Army News Service reports that acupuncture and other forms of alternative and complementary medicine are helping Army patients reduce the use of opioids to block pain. Brig. Gen. Norvell Coots, deputy commanding general of the U.S. Army Medical Command, testified at a recent hearing of the Senate Veterans Affairs Committee. He said that, in 2011, 26% of all service members were prescribed at least one type of opioid medication. That number was brought down to 24% last year, partly due to the use of acupuncture, yoga and other alternatives to medication. “It is a small difference, but I think it still represents a big cultural change and a move ahead,” Coots told the committee. He said that the Army has seen a big upswing in the use of alternative medicine in the past few years, and its use has been written into the Army’s Comprehensive Pain Management Campaign. “All the statistics are showing now that, with a big push for cultural change with integration of these alternative modalities, we’re seeing a downturn in opioid usage across the military, particularly across the Army,” Coots said. Robert Petzel, undersecretary for Health, Department of Veterans Affairs, told the committee that the VA’s treatment plan for pain now includes chiropractic care, massages, mindfulness meditation, exercise therapy and relaxation.
Research is also promising for chiropractic care. The National Institutes of Health (NIH) has found that chiropractic procedures relieve back and neck pain, headaches, and joint conditions like knee, hip and shoulder pain. NIH also reports that two out of three patients who visit a CAM provider for pain get needed relief.
It stands to reason that the healthcare system can achieve substantial cost savings when a chiropractor can save a patient from having back surgery or needing injections or addictive narcotics. Also, CAM offers a quicker return to work for the employees due to its all natural, less extreme treatment procedure, says Greg Clure vice president of Sales Landmark Healthplan of California.
A study by the Foundation for Chiropractic Progress (F4CP) finds that offering chiropractic services at onsite employee clinics lowers healthcare utilization and costs compared to offering off-site services. On-site chiropractic services are associated with lower utilization of radiology services and physical therapy, as well as fewer visits to outpatient and emergency settings. Study co-author Ross M. Miller, M.D., M.P.H., says that employers are seeking innovative solutions as the nation restructures its healthcare delivery system. Many companies with an on-site health center think that chiropractic care has a great potential to bring a higher return on investment.
Gerard Clum, D.C., a F4CP spokesperson says, “Doctors of chiropractic provide evidence-based care that is both non-pharmacological and non-invasive to address common problems, such as low back pain. By offering chiropractic on-site, employers significantly increase the opportunity for financial and clinical success.” Low back pain is one of the primary reasons for visits to U.S. healthcare providers, according to reports by the Mayo Clinic and Cleveland Clinic.
Standard Process Inc., a Wisconsin-based manufacturer of whole food supplements offers on-site chiropractic care. Charlie DuBois, president of Standard Process says, “We established our on-site health center more than a decade ago. Throughout the years, we have collected data and documented our experience, such as healthier employees, reduced healthcare costs and improved productivity and morale. Chiropractic care has always been a core service offered and is now recognized as a chief contributor to our program’s success.”
Clure says that the growing acceptance of alternative medicine has boosted worksite sales of CAM benefits. It’s not uncommon for medical doctors to recommend chiropractic or acupuncture for back or joint pain and chronic headaches, he notes. He finds that more groups are asking for this type of benefit. Most PPO and many HMO plans include a chiropractic/acupuncture benefit, but it is often limited or difficult and expensive to access. These benefits, which are subject to medical necessity, may require the user to pay an expensive deductible or co-insurance.
Stand-alone plans offer more options, Clure says. With medical necessity plans, the purchaser chooses from a variety of co-pays and office visit maximums, which can be different than what’s offered with their medical plan. Expanded plans don’t require medical necessity, and can be used for wellness or maintenance in addition to the treatment of a medical condition. With a standalone plan, the user only needs to pay their plans’ co-pay to access coverage without needing to meet any deductibles or pay a co-insurance. Clure says, “We renew 98.8% of our clients each year so the vast majority is very satisfied. Again, it comes down to a high-value, low-cost program that employees actually want to use.”
Clure’s first tip in selling CAM benefits is to quote it on every prospect and on every renewal. “The coverage generally sells itself, as it has such a low cost compared to a group’s medical coverage, with rates starting out a just $1.81 per employee per month for a small group and even lower for a large group. While most people would choose not to visit their medical doctor if it could be avoided, they have no avoidance issues with seeing their chiropractor every week as it makes them feel better after each and every visit.” Clure says that a number of brokers even purchase the benefit plans for their groups out of their own pockets as a way of adding value to their brokerage services and gaining a marketing advantage over their competitors. This leads to strong broker/client loyalty, and makes it easier for the broker to retain business and attract and gain new clients.
Leila Morris is senior editor of California Broker Magazine.