Health Insurance Companies Need to Increase Reimbursement Rates to Chiropractors

Petition for Fair and Equitable Reimbursement for Chiropractors by Insurance Companies

We, the undersigned chiropractors, patients, and supporters of natural healthcare, urge insurance companies to significantly increase reimbursement rates for chiropractic services. As healthcare providers dedicated to offering pain relief and improving overall wellness, we face a growing financial challenge in providing essential, life-changing care for our patients. The current reimbursement rates, especially for services covered by United Healthcare, Medicare, Blue Cross Blue Shield, and Florida Blue, are unsustainable and do not reflect the true costs of delivering quality chiropractic care.

1. The Inadequate Reimbursement Rates

In Florida, many chiropractors are reimbursed a maximum of $45 per visit by United Healthcare, with similar rates provided by other insurance companies such as Medicare, BCBS, and Florida Blue. These rates are far below the actual cost of providing care. To break it down:

• Commercial Rent: On average, the cost of renting a space for a chiropractic office in Florida is between $2,000 and $6,000 per month, depending on location.
• Electricity & Utilities: With rising energy costs, the average chiropractic office pays over $300 per month for electricity and other utilities, which continue to increase due to inflation.
• Staff Salaries: Chiropractors employ many workers, including administrative staff, licensed chiropractors, and support personnel. The average chiropractor's office employs 2-5 individuals, with the salary of each employee averaging $35,000-$50,000 annually, not including healthcare benefits, taxes, or other benefits. The current reimbursement rates make it difficult, if not impossible, to sustain these payrolls without cutting quality care.
• Student Loans: The average chiropractic student graduates with over $300,000 in student loan debt. Despite this, many chiropractors earn modest salaries in the face of these massive educational costs. The burden of student loans remains a significant financial challenge for our profession.

2. Insurance Companies are Profiting While Care Providers Struggle

Insurance companies, on the other hand, are reaping record profits while healthcare providers like chiropractors struggle to make ends meet. The discrepancies between what insurance companies are paying out for services versus what they are receiving in premiums is growing at an alarming rate. Recent data shows that the top five health insurance companies in the U.S. have posted billions in profits, yet they continue to reduce reimbursement rates for healthcare providers, including chiropractors, who offer affordable, non-invasive care. We are left fighting for every penny, while insurance companies pocket the difference.

3. Unfair and Restrictive Visit Authorization

Another alarming issue is the unfair and restrictive way insurance companies authorize visits. Many insurance plans claim to cover a set number of visits for chiropractic care, but in practice, patients are often authorized for far fewer visits than needed. For example, an insurance plan may advertise coverage for 30 chiropractic visits per year, but the actual authorization may only allow for 5-12 visits. In many cases, patients are limited to just 2-3 months of care, despite needing ongoing treatment for chronic conditions. This often leads to the unnecessary suffering of patients and forces chiropractors to repeatedly fight for payment for services provided.

4. Consumer Fraud and the Role of Third-Party Authorization Companies

This brings us to a key issue: the role of third-party authorization companies that act as intermediaries between healthcare providers and insurance companies. These companies often delay or deny authorization for necessary treatments, thereby increasing administrative costs for chiropractic offices. They are also incentivized to reduce reimbursement rates and approve as few visits as possible. In fact, the business practices of these companies could be considered one of the largest consumer fraud schemes in modern history, as they actively limit access to necessary care for the sake of profit.

5. The Benefits of Chiropractic Care

Chiropractic care provides a proven, affordable alternative to drugs and surgery for chronic back pain and other musculoskeletal conditions. Research has shown that chiropractic care is highly effective in reducing pain, increasing mobility, and improving quality of life for millions of patients. Unlike traditional treatments that rely on medication, chiropractic care addresses the root cause of pain without the harmful side effects of opioid drugs, which contribute to the opioid crisis and the growing fentanyl epidemic. Chiropractors are uniquely positioned to provide non-invasive pain management solutions that reduce reliance on dangerous substances and prevent long-term health issues.

6. The Economic Impact of Chiropractic Care

Chiropractors are not just healthcare providers—they are also significant contributors to the economy. According to the Bureau of Labor Statistics, there are over 70,000 chiropractors employed nationwide. These professionals support an estimated 300,000 jobs in ancillary industries, including office staff, physical therapy assistants, and support services. However, the unsustainable reimbursement rates are putting this vast workforce at risk.

7. The Need for Change: Fair Reimbursement for Sustainable Care

The reality is that the current reimbursement rates are unsustainable. Chiropractors cannot continue to provide high-quality care without fair compensation. As it stands, the current system puts us in a position where we must decide between maintaining quality care or remaining financially viable. This imbalance is not only damaging to healthcare providers, but it ultimately harms the patients who rely on us for relief.

Therefore, we call for the following actions:

1. Increase Reimbursement Rates: We request that insurance companies immediately raise the reimbursement rates for chiropractic care to reflect the true costs of doing business, including commercial rent, utilities, staff salaries, education costs, and other overhead.
2. End Unfair Visit Limitations: We demand that insurance companies honor their commitments to patients by covering the full number of authorized chiropractic visits, without arbitrary and unnecessary restrictions.
3. Investigate Third-Party Authorization Companies: We urge lawmakers and regulators to investigate the practices of third-party authorization companies, who are obstructing patient access to care in exchange for profit.
4. Support Chiropractic Care for Chronic Pain Management: We advocate for the recognition of chiropractic care as a critical component in the fight against the opioid epidemic and chronic pain management. Chiropractic care offers patients a safe, non-addictive alternative to pain relief.

The time to act is now. Chiropractors are vital to our healthcare system, and we must be supported fairly and justly. We ask for your help in ensuring that our profession can continue to provide affordable, effective, and compassionate care to those who need it most.

Dr. Michael Gampolo    Contact the author of the petition