Chiropractors Cracking Carriers’ Financial Backs
By Robert Warne - March 28, 2003The price tag on California’s workers’ compensation treating physician pie has increased dramatically since 1993. While costs associated with the clinic, orthopedist and physical therapist ingredients to make the crust have gone up, it’s the cost of the chiropractor filling that’s burning payor’s tongues.
The California Workers’ Compensation Institute (CWCI) released an analysis of the drivers associated with the costs of the chiropractic filling, March 21.
As the number one classified medical specialty group rendering treatment in the state, chiropractor-treated claims costs went from $77 million in 1996 to $195 million in 2001.
In the report CWCI unveiled the ingredients in the recipe that have helped chiropractors rise to the top of the treating physician charts.
Even though claims frequency declined since 1993 chiropractors have been able to make up the difference by increasing the cost per claim. The average total chiropractor cost per claim went from $1,455 in 1993 to $2,556 in 1998.
Keeping the meter running with an increased number of visits per claim is one of the contributing factors for the increased cost per claim. The average number of 20 chiropractor visits in 1993 grew to an average of nearly 30 visits in 1998.
The chiropractor fee schedule manipulation codes were changed in 1999 and a number of procedure codes were consolidated. But despite the consolidation the number of procedure performed by chiropractors has continued to increase.
Another CWCI observation is that the number of licensed chiropractors in California has increased dramatically since 1995, which has also contributed to the rise in chiropractic costs.
CWCI quotes Stanford University economist Dr. Victor Fuch’s definition of the economic principle of physician-induced demand. “If the physician/population ratio should increase…the result will probably be higher rather than lower fees and also more operations.”
AB 749 did make some adjustments to the presumptive of the treating physician which CWCI expects will have a positive impact on the cost trend. Another bill proposed this year that CWCI expects will chip away at chiropractor cost is SB 354.
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