CAM Policy Statement

ACA Position Statement on Complementary Alternative Care Programs
Over recent years there has been a resurgence of interest in alternative healthcare by the American public. This boom translates to good and bad news for the chiropractic profession.

On the positive side, chiropractic is one of the top two providers of choice according to a recent issue of the Journal of the American Medical Association. Total visits to alternative care providers have increased 50% since 1990 and now exceeds visits to all allopathic providers. Insurers are responding to public demand for alternative care options in two distinct ways.

One option includes chiropractic care being included within basic, mainstream insurance coverage. Evidence of this is reported in a Mercer Study indicating that 80% of HMOs, 91% of PPOs/POS and indemnity plans and a full 95% of employers offer at least one plan including chiropractic care.

Another plan option known as an affinity product is becoming popular with many national insurers/HMOs but does not necessarily reflect favorably on chiropractic care. An affinity program allows access to alternative care providers at a discounted rate. The treating provider, or doctor of chiropractic, provides a discount ranging from 15-40% of his/her usual charges. The enrolled patient (insured) pays the insurer (HMO) for access to the chiropractor but must pay cash for the service. The insurer pays nothing toward the care (some insurers allow the initial visit but no follow-up care), but promotes the plan to existing and potential insureds as being an extended or additional coverage.

The ACA has long opposed contractual exclusions and other efforts aimed at omitting chiropractic from insurance and benefit plan coverage. ACA policy has long been directed to work for full inclusion of chiropractic in "all public and private health programs" [ACA Policy Statement on Insurance Contract Exclusions and Insurance Equality, Ratified by ACA House of Delegates, June 1975]. In addition, the ACA has stood with the patients of chiropractors and has taken aggressive steps to protect a patient's right to receive the chiropractic benefit he or she is entitled to receive [See, ACA v. Shalala, C.A. No. 98-2762].

The affinity product moves chiropractic away from mainstream insurance coverage. The ACA believes doctors of chiropractic should maintain physician status within any kind of health care benefits program and opposes insurance exclusion. The ACA believes chiropractic care should be a benefit within all third party payer plans or programs. It is the view of the ACA, that affinity programs that claim to offer additional covered benefits, when in fact the insured and the doctor assume all financial risk, mislead the public.