The American Chiropractic Association (ACA) hosted a historic Stakeholder Collaborative Forum on Jan. 26 at Northwestern Health Sciences University to delve deeper into the current market need for chiropractors in combating the opioid crisis as well as issues related to chiropractors working within or in collaboration with hospitals and health systems. Michele Maiers, DC, PhD, facilitated the meeting with the primary goal to identify industry trends and how to position members to be successful. Several qualities were identified and work groups were established to help guide ACA in the creation of toolkits we can provide for our members.
As part of its brand promise of embracing patient-centered and collaborative care, ACA recognized the importance of moving the profession forward by taking action and creating an opportunity to bring together multiple stakeholders to discuss mutual issues of concern. The goal of the January forum was to gather various perspectives and insights into the value proposition for chiropractic in treating musculoskeletal pain. Stakeholders at the forum included patient advocates, chiropractic universities and students, private and public payers, purchasers, other health care providers, VA representatives and chiropractors representing private, integrated and corporate practices.
In the current health care environment, there are many forces—both internal and external—that require health care stakeholders to examine their traditional relationships. Many stakeholders are being both pulled apart and pushed together in new ways by these changes, which include increased direct employment of chiropractors, providing alternatives to opioids, new payment methodologies from public and private payers and the need to deliver greater value in an increasingly competitive marketplace. ACA’s collaborative forum focused on benefit design, providing information to consumers and other health care providers, defining best practices for conservative providers and increasing the presence of chiropractic in the marketplace. These topics are essential to addressing pain management in the wake of the opioid crisis, in particular changing the point of entry for the early treatment of musculoskeletal pain–chiropractic first.
There were robust discussions during the forum on identifying the key professional practices that are common among exemplary integrated clinicians and organizations. The collaborative care model has transformed the roles, responsibilities and practices of clinicians on integrated health care teams. While models of integration may differ in structure and process, each approach requires the clinician to take on new functions and tasks to shift toward comprehensive, team-based care. There is also a need for the infrastructure to adjust. The stakeholders at the forum tackled opportunities and barriers of benefit design, including proper coverage and incentives as well as the need to provide evidence and guidance to health systems and other providers on how to align care pathways with the American College of Physicians’ updated low-back pain treatment guidelines and identify patients with conditions that would benefit from receiving chiropractic services as a first intervention.
The Stakeholder Collaborative Forum was a first step in developing resources and tools for identifying and adopting best practices that not only enhance outcomes but also create greater consensus regarding patient care among chiropractors, payers and policymakers. The outcomes of this collaboration will also help drive aspects of ACA’s education strategy moving forward.
Not all chiropractors seek integration or a role in curtailing the opioid crisis. However, for chiropractors who do choose to work in collaboration with other health care providers or in an integrated health system, ACA’s goal is to provide information to assist in their ability to serve patients. While challenges exist, they are not insurmountable when professionalism, respect and cooperation are at the core of this partnership and when there is a clear vision of how best to meet the needs of the patients and communities we are privileged to serve.
Dr. Kennedy is ACA senior vice president of health policy and education.