The cost of healthcare is going up, the cost of insurance is going up, and the cost of doing business is going up. Insurance payments to chiropractors are not going up and in some cases, the reimbursement is going down. That is why some chiropractors do not take insurance.
Growing up in a small town in Idaho my parents always pushed “get a good job with good benefits so you don’t have to worry and can take care of your family”. Isn’t that the American dream I would think to myself. Be a productive member of society and you will be rewarded with a mediocre salary, medical coverage, a 401k match, and 3 weeks of paid vacation. I mean for most that sounds like a great way to start your working career.
It was not until I became a healthcare provider that I realized most people’s dreams are not what their parents had hoped for them. Long hours at the office, still mediocre pay and those health benefits are not all they were cracked up to be….
I had a patient last week lose his mind on my staff as we tried to explain his benefits to him. You see “Greg” (this is not his name but what we will refer to him as.), works a decent job locally, and has decent medical benefits. He is allowed 18 chiropractic visits a year and he only has to pay for 20% of the bill while his insurance will take care of the other 80%. What Greg did not understand is he has a $4000 deductible that he must “hit” before his insurance company will contribute.
Of course, Greg will never accumulate $4000 worth of care in our office so his entire bill was going to be the full amount out of pocket. This is usually the moment that patients walk away sheepishly because they have argued with our staff only to realize that their “benefits package” with their employer is not a valuable perk unless they need major medical intervention.
Let’s flip sides to the value of insurance in the chiropractic office for the providers. It wasn’t until the 90’s that insurance companies started covering chiropractic care. It is speculated that the stronghold of the American Medical Association lobbyists on the insurance companies stopped coverage from ever being provided until the dawn of the internet. In the 90s, at the stroked of a key, patients were able to research treatment options and many chose chiropractic for their health care needs after learning about its benefits on the world wide web. Insurance companies answered the demand by raising premiums for their policyholders while minimizing payouts to the “in-network” providers.
One of my partners graduated from chiropractic school in 1979. He reminds me that they charged $30 an adjustment back then. As of today 11/1/2022, most insurance companies will reimburse a chiropractor between $28-$40 for the same treatment. Because these reimbursement rates do not commiserate with the current cost of doing business many chiropractors have opted out of taking insurance and find more value in providing quality care without insurance oversite.