Translating Chiropractic’s Value

Advocate uses similar approach to win over legislators and health plan administrators.

After success in getting all Missouri’s members of the U.S. House of Representatives to cosponsor Medicare and TRICARE modernization bills (H.R. 3654 and H.R. 344, respectively), ACA Missouri Alternate Delegate Quinn James, DC, is continuing his efforts on the local level. He recently began looking at self-funded plans in the St. Louis, Mo., area and finding flaws in their benefit designs.

Dr. James decided to approach a local electricians’ union, whose plan offered 24 chiropractic visits per year for members but none for their spouses or dependents. After speaking with a few patients that work for the union and obtaining contact information for a nurse that works in the union’s health and welfare division, he crafted an informative letter that the nurse later reviewed with the benefits administrator and health board.

Thanks to this action, the electricians’ union now covers services offered by chiropractors for members’ spouses and dependents. The union includes more than 5,000 active members and more than 900 retirees under its health plan, and their spouses and dependents now have access to chiropractic care.

ACA Blogs reached out to Dr. James to learn how approaching a union about chiropractic benefits might be different than approaching federal legislators, and how others can do the same:

How do you choose which organizations to approach? 

I look for organizations that are local. It helps when finding and creating key contacts that can help to open a door and put you in contact with a decision maker.

How is approaching a union different than approaching a legislator? 

It is really not very different. Whether it is a union or legislator’s office, you must find the key contact within the organization. I will often ask patients, ask other chiropractors, search the internet, or call to find out who oversees health policy. I have several local chiropractic offices that help put me in contact with decision makers at companies. I always pitch including chiropractic physicians in a health plan as a cost-savings tool and a tool to lower opioid prescriptions.

What made you choose this union specifically? 

I chose the union because I had a couple patients who were being negatively affected by the chiropractic policy in place. It specifically excluded spouse and dependent coverage for chiropractic. I look for companies that offer no chiropractic coverage or limited benefits.

Are there specific pieces of information that stand out to people you contact? 

I use the exact same information I use for H.R. 3654: Joint Commission R3 report, National Association of Attorney Generals letter to AHIP, article from Sept. 26, 2019, MO Healthnet (Missouri Medicaid) fiscal analysis, and UHC/Optum cost savings analysis/waived copay and deductible information. (Read the letter written by Dr. James to the union.)

What questions are you asked about chiropractic coverage?

I have gotten a few questions regarding the cost savings and I simply point them to the UHC/Optum slide and the fiscal note from the Department of Social Services on MO Healthnet. I also explain that when you add chiropractors to a health plan it does not add any new conditions; it simply creates increased competition for dollars already being spent. We know that chiropractors lower costs by decreasing unnecessary tests, procedures and prescriptions. Almost every health plan has an opioid reduction program in place and our services complement these policies perfectly.

What advice do you give others? 

Reach out to your legislative chair or lobbyist of your state chiropractic association. They can guide you on lobbying 101. Spending a day with an experienced doctor or lobbyist can go a long way.

You seem to be on a roll! What organization will you approach next? 

I have already approached St. Luke’s Hospital in Chesterfield, Mo. It is the only hospital in the St. Louis area that does not cover services offered by chiropractic physicians.

Roughly how many hours per week do you spend on your advocacy efforts?

I spend three to six hours per week working on advocacy for the chiropractic profession.

What keeps your momentum going?    

Results keep me going…and my persistence is paying off!

Is there anything else you would like chiropractors to know? 

Get started on the local level and start building your network and key contacts. Be involved with your state association and find where your passion is.