In the workers' compensation marketplace, chiropractic care has been tolerated but not well regarded. This popular physical medicine treatment option often suffers from the stigma that "chiropractors never resolve claims, rarely file timely reports, and always recommend ongoing treatment," according to Hope Owen, workers compensation manager for Landmark Healthcare, Inc. (Sacramento, Calif.), a managed care company that targets group health, workers' compensation and Medicare populations for alternative health therapies.
So when Landmark launched its chiropractic managed care program for workers' comp in January 1997, its greatest challenge was creating an integrity level for chiropractic care and developing a more mainstream appeal for the treatments.
Using an aggressive educational campaign, Landmark is making headway with convincing its target of workers comp managers that chiropractic care doesn't have to result in open-ended claims. So far, it has landed 15 managed care contracts, which represents $250,000 in revenues. Its goal is to sign up 100 contracts ($750,000 in revenue) by year-end.
In spite of the bad rap that chiropractic care has gotten through the years, state law has been on the side of chiropractic care. For patients who elect to receive the alternative treatment, chiropractor case managers can determine any length of treatment they deem necessary.
In addition, market research painted an optimistic picture for Landmark to achieve its marketing goals. Fifty percent of all work-related injuries (usually minor neck, shoulder and back injuries) can be treated with proper chiropractic services.
'Controlled Care' Messages Get Target Attention
To get the ear of its target - primarily self-insured employers with 500 or more employees, third-party administrators and insurance carriers - Landmark's marketing messages focused on "controlling the care of chiropractors." Owen's four-member marketing team plugged away at an education strategy for five months that emphasized Landmark's 700 licensed and credential providers and how quality chiropractic care can be a more efficient option than conventional medical care.
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Making a Case for Chiropractic Care
Landmark looked to impressive market research numbers to combat some of the negative stereotypes of chiropractic care. As part of a booming $14 billion alternative care industry, chiropractic services continue to get high marks for patient satisfaction, an issue managed care companies are finding hard to ignore. Landmark's research arsenal highlighted:
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But Land- mark's promotional hook was its assertion that most of the chiropractic claims it handled would be closed in three to five months. This was a key selling point because most chiropractic claims not handled through a managed care program take anywhere from eight to 11 months, according to Owen.
To get the word out, Landmark spent most of its $220,000 marketing budget on a mix of employer-based and consumer-oriented workshops, seminars and engagements that required guest speakers. It spent 34 percent, or $75,000, on collateral materials and direct mail to nearly 1,000 California managed care decision makers: employers, adjusters and risk managers.
Switching Gears
Initially, Landmark touted the fact that its managed care chiropractic program, if used as an early intervention component, could save the employer at least 38 percent in physical medicine annually. But this message wasn't as convincing as Landmark's marketers thought it would be. "The marketplace was saying that they needed help after a certain time frame [on the back end of claim filing process] and not necessarily in the early stages," said Owen.
To respond to the market's needs, Landmark retooled its workers' compensation packages so that employers could use them during any stage of the decision-making process. Owen's marketing group drafted some key risk factors that conveyed when Landmark should be brought into the workers' comp loop which included:
- Vague physician diagnoses;
- Incomplete evaluation records on chiropractic care;
- Continuous chiropractic treatment for more serious injuries that might require outside medical treatment.
These risk factors provided easier access points for employers that wanted to try Landmark out on a trial basis. A case in point is Keenan/Innovative Care Systems, a workers' comp third-party claims administrator in Rancho Cordova, Calif., that handles claims for companies in the private and public sectors statewide.
Landmark was brought on board in April to review Keenan's back injury claims and to clean up some old claims that had not been resolved, according to Gary Archibald, Keenan's president. For Archibald, chiropractic services still have a long way to go in "proving what they do and representing the [effectiveness] of the work," but Landmark's program seemed to address those shortcomings.
After working with Landmark for a few months and realizing a 20% to 25% savings, Keenan is referring all of its chiropractic claims to Landmark which amounts to about 10 claims/month. (Landmark, 916/569-3326; Keenan/ICS, 800/435-1123)