We’ve met with thousands of patients through the years providing conventional and alternative treatment options including medical procedures, physical therapy, and chiropractic for a broad spectrum of conditions such as headaches, neck pain caused by ligament laxity, sprain or strain to joints, degeneration or herniation in the spine, and osteoarthritis affecting spine and joints. We’ve also consulted with them regarding their insurance coverage for procedures that included medical exams & procedures including pain management injections, diagnostics such as biopsies, NCV/EMG, x-rays & MRIs, physical therapy, chiropractic and durable medical equipment (DME).
Over the past seven years, we recognized the changing dynamics of health insurance coverage which were creating greater out-of-pocket costs for a majority of our patients with each passing year. Even if a patient was double-covered or purchased a plan through the Health Insurance Marketplace, the premiums to have these coverages were increasing and many of our patients complained that there were still high out-of-pocket costs associated with the care they would like to choose or lots of limitations. Also, over the last several years, the insurance industry (federal and commercial) has made an effort to reduce their payment of claims in the rehabilitative medicine area and certain medical injections by increasing policy restrictions, bundling or reducing the amount payable to providers and increasing the patient’s out-of-pocket amounts such as copays. There have also been heightened efforts to go back to the doctors and recover monies previously paid for services (which has been extended to 5 years via the middle-class relief act). Basically, these changes, limitations and costs have created several problems:
1) Difficulty for the patient to receive the care without significant costs.
2) Difficulty for the provider to give the care and be paid for it.
3) Difficulty of meeting restrictive policy limitations and guidelines.
Our best patient outcomes have been achieved by combining medical procedures such as injections with physical therapy or otherwise known as a multimodal approach. For example, as a fully accredited Osteoarthritis Facility, we introduced a Knee Osteoarthritis 8-Week Knee Protocol (USPTO 9,226,938) to Utah in 2009 using visco-supplementation injections with physical therapy. We were included in a study published in October 2013 reporting positive outcomes that included 66 treatment facilities in the U.S. The study can be found here. We introduced a multimodal Neuropathy Protocol in 2012 and a multimodal Headache Protocol in 2013.
During the time we offered these treatments we would get these kinds of questions from our patients:
- Can I have access to an exercise plan that I can do at home or at my gym on my own time without the additional costs of a visit to the clinic?
- Isn’t there something that can regenerate the cartilage in my knees?
- What can I do to avoid surgery in my…neck, back, knees, hip, etc.?
- What can I do to be able to continue to work?
- Do I really have to pay for another doctor visit, to have this test, this MRI, etc?
This small shift in thinking lends itself to the thought, how much more cost effective would healthcare be if our patients who desired to maintain and manage their own health had access to simple tools to do so? How much money could they save by having access to wellness care rather than sick care? If instead of waiting for the next time their back gave out, they were actively participating in exercises, quality diet and regular chiropractic care to maintain their health? Perhaps the changes in a government mandated healthcare are just what we need to help us make that shift in thought process.
We heard our patients’ desires for more affordability and accessibility to the kind of healthcare designed to improve the quality of life and we determined to find solutions. We also wanted to continue to do what we enjoy which is to help them feel better and have access to a better quality of life.
Here are the solutions we provide –
We offer physical therapy specific to a patient’s condition via computer, tablet, or smartphone (printed hard copy available as well) that can be performed at home or at a gym.
For maintenance care, we offer affordable monthly plans for chiropractic, nutritional and supplementation guidelines, and weightloss solutions. 60% of us over the age of 40 already have some degeneration in our backs. This means we need to take an active-care approach which should include chiropractic, regular stretching/exercise and evaluated nutritional support for our condition.
Personal injury coverage or med-pay benefits are available in Utah to patients who have been in an auto accident (there is a minimum of $3000.00 no fault injury coverage on Utah car insurance policies). Our auto injury patients experience coordinated care in our facility with access to medical and rehabilitative care.We have a secure platform with virtual access to medical providers to oversee the entire case as well as provide medical procedures in the facility. Through our affiliation with IASIS we can easily coordinate with a network of providers for additional services.
Regenerative medicine is here to stay and whether it’s PRP, prolotherapy, ozone therapy, autologous stem cell therapy or placenta-derived allograft, these procedures are being sought after by individuals who would like pain relief and to avoid the possible complications of surgery. We’ve had a few years to research and learn of various regenerative options and we offer a placenta-derived allograft. It does not require a “donor” match, is delivered by following FDA regulations for donated tissue, and has an extra-cellular matrix with stem cells which is like a “power-pack” for healing and regenerating tissues. We have had positive clinical outcomes for knee osteoarthritis, degenerative neck/back, ligament laxity, shoulder osteoarthritis, plantar fasciitis, severe ankle sprain and other conditions.
With the exception of personal injury insurance, we are a cash only practice. This keeps our administration costs down, and allows us to provide services to our patients that we consider the most effective and not dependant on “what the insurance will cover.” We do work with medical providers who accept insurance and for certain services as we recognize this may be the best option for our patients. We also have relationships with providers who have affordable cash prices for their services. We are an IASIS affiliated clinic which means we have access to a network of medical professionals to provide care and treatment that we do not provide.
This explains a little bit about why we do what we do, how we see the world of healthcare evolving, and where we find we best serve our patients and community.