As we celebrate our 25th anniversary as the definitive news and information source for the chiropractic profession, we look back at the important events as reported in DC since 1983, while also looking forward to the future. Throughout 2008, we will feature a review of the top headlines in chiropractic for a given year, along with an article on the future of chiropractic authored by an influential member of the profession.
January 2007: Foundation to Run First Television Commercial
On Jan. 6-7, 2007, during the Fox Network's airing of the 2007 Ms. Fitness USA contest, the Foundation for Chiropractic Progress (FCP) will run its first television commercial promoting the benefits of chiropractic. The commercial also will air on Jan. 15, when Fox re-runs the contest. Overall, the FCP expects the commercial to be seen by an estimated 150 million households across the nation.
As with the foundation's ongoing national print advertisements, the commercial will feature Sarah Harding, Ms. Fitness USA 2006, who will share a message about how chiropractic has allowed her to maintain an active lifestyle. The FCP also is preparing a commercial of Ms. Harding that will be made available to state associations that are partners of the foundation's media campaign.
"We believe that as the reigning Ms. Fitness USA, Sarah will have a tremendous impact on the viewing audience," said Kent S. Greenawalt, founder and president of the foundation.
The FCP kicked off its advertising campaign in July 2006 with regional ads in four major publications, and is now running national ads that will reach more than 12 million subscribers by early February of this year. In the past few months, the ad has appeared in national issues of Newsweek, Business Week, U.S. News & World Report and The New York Times Magazine.Health magazine will run the ad in its Jan./Feb. 2007 issue, which hits newsstands on Jan. 5, 2007; Newsweek will run the ad in its Feb. 12, 2007 issue, available on Feb. 5, 2007.
January 2007: Unity in Michigan
As of Jan. 1, 2007, the Michigan Chiropractic Association (MCA) and Michigan Chiropractic Society (MCS) are now operating as a single entity. Michigan chiropractors ended 2006 with a resolution of unity, as the two state membership organizations voted to function together as the Michigan Association of Chiropractors (MAC). In early December, the boards of both organizations voted to merge, and on Dec. 29, 2006, members of the MCA and the MCS voted to approve the merger, paving the way for a unified chiropractic profession in the state.
A joint press release issued by the MCA and the MCS explains the reasoning behind the unity effort: "After years of operating separately, the differences between the two organizations have diminished and their need for a unified effort has increased. The organizations have begun collaborating recently, most notably during efforts to improve Michigan's scope of practice legislation and in legal actions against discriminatory insurance practices. Additionally, the merger will reduce duplication allowing the profession to devote more resources to public education and public-policy initiatives."
Prior to the Dec. 29, 2006 member vote, a joint venture agreement, plan of consolidation and a new set of bylaws already had been ratified by the boards of both groups to ensure a smooth transition. In addition to the mission statement and purpose, the bylaws also address organization structure, membership, districts, board of directors, executive committee, executive director, elections, officers' duties and responsibilities, committees, meetings, manner of adjudicating complaints against individuals, officers and committees of the organization, fiscal business, amendments to the constitution and bylaws, saving clauses and a code of ethics.
The MAC will hold its first district elections in the fall of 2007. New officers and board members will begin serving in January 2008. Until that time, the interim MAC board will consist of current MCS and MCA board members. Following the fall 2007 elections and the installation of the new board in early 2008, the MAC will be divided into eight districts, based on geographical factors, the number of doctors in each region, etc. A board of directors, comprised of two representatives from each district, the past president, president and vice president, will govern the affairs of the new organization. The current executive committee includes Drs. Thomas Klapp, chairman; Kirk Steketee, president; Donald Reno, vice president; Eric Seif, director of financial affairs; and Robert Markle, director of internal affairs.
April 2007: OSCA Launches "WellCare Revolution"
The Ohio State Chiropractic Association (OSCA) has launched a statewide WellCare Revolution campaign featuring Ohio State University All-American and four-time National Football League Pro Bowl linebacker Chris Spielman; Olympic gold medalist and former OSU track-and-field star Butch Reynolds; and central Ohio family practitioner and chiropractic advocate Brad Herpolsheimer, MD. Circone + Associates, the advertising/marketing firm handling the campaign, emphasizes that broadcast television spots featuring the three celebrity endorsers are just one component of a comprehensive repositioning effort, designed to engender public trust in the chiropractic message.
In May 2006, James Woodward, the newly appointed executive director of the OSCA, and Brad Circone, president of Circone + Associates, went to work to change the face of chiropractic for the state of Ohio. They produced the first-ever chiropractic "brand anatomy," a sort of marketing roadmap that repositioned and differentiated the Ohio chiropractic profession's selling attributes and service offerings, both philosophically and in practice processes.
In creating the correct strategy for repositioning, Circone + Associates performed a plethora of rigorous research endeavors, including surveys, personal interviews and reverse-modeling studies of like and dissimilar industries, in seeking unique correlations for chiropractic change and acceptance. Extensive surveys were conducted regarding current chiropractic perceptions as garnered from three distinct populations: practicing chiropractors; their current patients; and the general public, in order to advance the chiropractic position as a statewide initiative for the association and its members.
The facedown marketing solution of this "brand anatomy" became what the OSCA now titles a "WellCare Revolution" - an everyday alternative, vested care system, extending beyond the health and wellness confines of traditional health care. WellCare, as defined by the OSCA, is the combined investment of consistent complementary therapies for three primary occurrences: pre-health care and preventative lifestyle wellness, resolution of acute pain, and performance enhancement; all care episodes working to stabilize and sustain the body, mind and spirit. WellCare describes itself as habitual care maintaining the harmony of the body and the sanctity of the mind. Its characteristics embody preventative, stabilizing, self-directed health care, incorporating alternative health and wellness therapies.
Phase one of the statewide campaign launched with March Madness (March 12 and 13), airing on both the 6 p.m. and 11 p.m. editions of ESPN SportsCenter, as well as buys on the FOX News Channel and the Learning Channel, blanketing all Ohio demographic market areas (DMAs) and continuing through May 28. The media plan is designed to hit more than 98 percent of Ohio cable subscribers, or about 3.5 million households. Phase two is planned to commence in September 2007, with phase three following in 2008. After February 2007 viewings during a seven-city screening tour, Ohio doctors of chiropractic appear to be quite impressed with the commercials.
September 2007: Fighting Back Against Managed Care
Insurance reimbursement is a contentious issue in many states, particularly in the past several years and particularly with regard to inadequate/unfair reimbursement to doctors of chiropractic. The latest examples: The Michigan Association of Chiropractors (MAC) recently won a key insurance battle against Blue Cross Blue Shield for excluding DCs from performing services within their legal state scope of practice, while New Jersey insurance regulators imposed a hefty fine on Aetna for denying care provided by out-of-network providers.
In July, Michigan Insurance Commissioner Linda Watters declared that Blue Cross Blue Shield of Michigan's (BCBSM) Healthy Blue insurance options were unlawful. The ruling came after the Michigan Association of Chiropractors (MAC) filed a lawsuit against BCBSM, alleging that Healthy Blue policies excluded doctors of chiropractic from performing physical medicine modalities and other services within Michigan's chiropractic scope of practice.
Watters ruled that once BCBSM offers coverage for a particular medical service, it cannot exclude a class of providers from being paid for that service, so long as the provider is authorized by law and professional license to administer that service. Watters also stated that Blue Cross could not exclude spinal manipulative therapy from its coverage unless the exclusion equally applied to all provider groups. This means that policies cannot discriminate against one provider group (e.g., chiropractors) while allowing other providers to perform the excluded service.
Finally, she stated that DCs must be treated in the same manner as other providers authorized to provide physical therapy, provided they are permitted by scope and licensure to perform such services. An attorney for Blue Cross has stated that the company will be "correcting" its My Blue policies to conform to the commissioner's decision in the Healthy Blue Case.
Meanwhile, in a win for all health care providers and residents of New Jersey, the state Department of Banking & Insurance (DOBI) has levied fines of nearly $9.5 million against Aetna Health, Inc., for refusing to provide fair reimbursement for certain services performed by out-of-network providers, which is in violation of New Jersey rules and regulations. In some cases, these services included emergency care. A spokesperson for the New Jersey DOBI said the fine is the largest ever levied by the department against a health insurer.
In June, the DOBI received numerous complaints after Aetna issued a letter stating it had determined "fair payment" for services provided by non-network physicians, hospitals and other health care facilities. The letter stated that "additional reimbursement would not be considered." Some of the disallowed services by nonparticipating providers were required under New Jersey law, such as emergency care, services provided by nonparticipating providers during an admission to a network hospital, and services rendered as the result of a referral or authorization by Aetna.
Aetna considered 125 percent of the Medicare allowable amount to be "fair payment," and 75 percent for lab fees and durable medical equipment. As a result, many patients received hefty bills to make up the difference for the amount Aetna refused to pay. However, New Jersey regulations state that members of an HMO have the right to "be free from balance billing by providers for medically necessary services." DOBI Commissioner Steven M. Goldman also ordered Aetna to stop its limited reimbursement practice, reprocess all claims for services rendered by affected nonparticipating providers, and pay those providers the billed amount, plus 12 percent interest from the date the claim was first paid. Aetna was given 30 days to request an administrative hearing in response to the commissioner's ruling.
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