In January 2014, major provisions of the Affordable Care Act (ACA) are scheduled to take effect – and implementation of advanced delivery models that aim to optimize outcomes, cost savings and patient satisfaction will become the primary goal of healthcare.
The Accountable Care Organization (ACO) is a key model that meets the vision of the ACA through its deliverance of coordinated, high-quality care by integrated groups of doctors, hospitals and other healthcare providers. It is able to operate efficiently and ensure commitment to healthcare improvement by all stakeholders through a transfer of more control and “accountability” to the practitioners and patients.
This new level of responsibility has individuals pressed at every level of healthcare — from policymakers to care providers, health economists and politicians − to seek out healthcare services that offer the most value. Chiropractic care is positioned as a key value contributor in the delivery system, especially when considering the elderly population.
Chiropractic care is a common alternative healthcare choice for the elderly. As individuals enter Long-Term Care (LTC) facilities and are empowered under the new federal health law to choose desired providers, it is probable that they will request the types of healthcare they received prior to admission. Chiropractic care — which involves several techniques, including manual spinal care (referred to as “chiropractic adjustments”), soft-tissue approaches, nutritional and exercise guidance as well as lifestyle recommendations — has been shown to be a popular choice that can be successfully integrated into an LTC facility. When integrated into a university-based facility, chiropractic provided a safe, conservative option that ranked “highly satisfactory” among LTC residents.[1]
Doctors of chiropractic are well-positioned to play an important role in health promotion, injury and disease prevention, and on geriatric care teams. Relative to musculoskeletal complaints, most geriatric healthcare providers have a limited number of options to offer elderly patients. In the spectrum of provider-assisted care for low back pain, chiropractic care is among the least invasive, least dangerous and least expensive approaches to be considered. Chiropractic adjustments are recommended by the Agency for Health Care Policy and Research for the care of acute low back pain in elderly patients. In addition, the American Geriatric Society Panel Guidelines for the Management of Chronic Pain state that non-pharmaceutical interventions, such as chiropractic, may be appropriate.[2]
For advanced systems, such as ACOs, chiropractic care provides potential for greater clinical efficiency, patient satisfaction and cost savings than is currently available. In January 2014, the number of ACOs in existence will surpass its current total of 428. In preparation to provide the coordinated, high-quality care mandated, national accreditation organizations, including URAC and the National Committee for Quality Assurance (NCQA), have begun to develop credentialing processes for the inclusion of chiropractic services in advanced delivery models.[3] Especially for the elderly population in the LTC setting, complementary and alternative care, such as chiropractic, will be an area of high interest, due to its “high touch,” noninvasive and non-pharmaceutical nature.
For more information about chiropractic care and its role in healthcare, visit: www.yes2chiropractic.org.
Gerard W. Clum, D.C. is the spokesperson for Foundation for Chiropractic Progress and the president emeritus of Life Chiropractic College West.
[1] Dougherty, PE and Killinger, L. Role of chiropractic in a long-term care setting. Long-Term Care Interface 2005; 6:33-8.
[2] Killinger L, DC. Chiropractic and geriatrics: a review of the training, role, and scope of chiropractic in caring for aging patients. Clinics of Geriatric Medicine (2004); 20: 223– 235.
[3] Foundation for Chiropractic Progress. Accountable Care Organizations Optimize Outcomes, Cost Savings and Patient Satisfaction with Chiropractic Care. http://www.f4cp.com/accountablecareorganizations/; Accessed 6.2.13.
