Over-utilization of Chiro. Care Hurting Calif. WC, AIA Says

Legislation to curb over-utilization of chiropractic care without physician oversight will help control the skyrocketing medical costs that are jeopardizing California’s workers’ compensation system, said the American Insurance Association (AIA). SB 354, authored by Senator Jackie Speier (D), would require injured workers to obtain a doctor’s referral before they can receive more than 15 visits to a chiropractor under the workers’ compensation system.

“Out-of-control medical costs are forcing private and public employers to pay the highest workers’ compensation costs in history,” says Mark Sektnan, AIA assistant vice president, western region. “Studies show that chiropractic use is much higher in California and there are no limitations on the number of visits an injured worker can make. Many other states, including Alaska, Arizona, Florida, Hawaii, Kansas, North Carolina and Washington, have set limits on chiropractic visits to bring medical costs under control. SB 354 would reduce unnecessary medical treatments and manage costs without denying appropriate medical care. If the legislature does not enact reform, medical expenses will continue to escalate and employers will face even higher workers’ compensation costs.”

Studies by the California Workers’ Compensation Institute (CWCI) and the Workers’ Compensation Research Institute (WCRI) indicate that chiropractic care is an increasingly expensive and over-utilized form of treatment for industrial injuries in California.

“CWCI found that workers’ compensation insurer payments to chiropractors rose 153 percent from $77 million to $195 million in just five years,” said Sektnan. “A study by WCRI also uncovered that costs for chiropractic-directed care are 30 percent higher than physician-directed care for non-surgical back problems and that chiropractic utilization is much higher in California than other states. SB 354 would rein in runaway costs without jeopardizing medical care for injured workers,” explained Sektnan.

SB 354 is similar to a system adopted in Oregon. During the 1980s, Oregon’s workers’ compensation system ranked among the most expensive in the country, while providing some of the lowest benefits to injured workers. In 1990, Oregon adopted legislation to limit the number of chiropractic visits to 30 days or 12 visits without further authorization by a doctor. Prior to implementation of these utilization controls, chiropractic care accounted for 16 percent of medical treatments costs. By 2000, the Oregon Department of Consumer and Business Services reported that costs for chiropractic care had dropped to 2.6 percent of medical treatment costs, resulting in almost a $26 million savings.

“Oregon’s experience and the study of California’s system demonstrate that the time has come to curb out of control utilization, said Sektnan.