AMERICAN COLLEGE OF

CHIROPRACTIC CONSULTANTS

OFFICIAL NEWSLETTER - Volume 1, Issue 1 Winter / Spring 1997

Executive Board:

Warren Jahn, DC - President / Thomas Snyder, DC - VP / David Cox, DC - Secretary
Karl Zimmer, DC - Treasurer / John Radabaugh, Jr, DC Past Pres /
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William Tellin, DC - ABCC Pres
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Jeffrey Cates, DC - Co-editor / Jeanne Lapp, DC - Co-editor

This newsletter is a service of the American College of Chiropractic Consultants and is designed to provide readers with pertinent information concerning the College, its examining board (ABCC) and utilization management activities.

Readers may save and use information contained therein only for personal use. No other use, including reproduction, transmission or editing, of the newsletter information may be made without the prior written permission of the ACCC, which may be requested by contacting the ACCC headquarters.

ACCC makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information printed within, and the ACCC assumes no responsibility or liability regarding the use or misuse of such information.The opinions expressed in the ACCC newsletter are not necessarily those in the College Advertisements appearing in the ACCC newsletter do not imply approval nor endorsement. Providers should consult their respective state licensing boards concerning the use of advertised products or services.

Mission Statement

The American College of Chiropractic Consultants (ACCC) aspires to advance and encourage programs which educate all utilization management professionals to reach their highest levels of achievement- intellectually, scientifically, accurately and ethically. The ACCC strives to promote the highest standards of utilization review (UR) and quality assurance (QA). Our members strive to deliver fair, accurate, timely, ethical, clinical and scientific consensus based utilization management activities. Through our mission, the ACCC will empower its members to be advocates for scientific and clinical truth and justice, serving their clients with fairness and integrity.

The Health Care Game: Cutting Costs But Not Quality

The health care industry has evolved from an industry with few rules to one that must compete, like any other product, on the basis of quality and price. Managed care companies are challenged to find better ways to limit costs without compromising the quality of care. In the near future, as profit margins narrow, the success of a managed care organization will depend on its ability to demonstrate value, which is where outcomes management becomes crucial. (Best's Review, 8/96, p.33)

ABQAURP is a group of certified health care professionals that are distinguished by their skills in QA/UR. They offer classes and examination that lead to becoming a certified Diplomate of ABQAURP. ABQAURP publishes an annual directory of diplomates that is published and made available to potential employers.

Recently five members of ACCC took the certification test, which emphasized government legislation, managed care, and current concepts of utilization review. Members interested in obtaining more information may e-mail us at drwjahn@ix.netcom.com.- ABQAURP is located in Tampa Florida.

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Antitrust Rules Eased For Physician Networks

For doctors trying to compare with managed care plans, relief is on the way. Federal regulators are making it easier for physicians to form their own care networks without running afoul of antitrust laws. The federal Trade Commission and the Justice Department said recently that they will apply a more flexible legal standard in determining whether many physician-run networks are anti-competitive. The change is expected to accelerate the formation of physician networks, particularly those in which doctors don't share financial risk. (The Wall Street Journal 8/29/96 p. B2)

The Backlash of Managed Care

With managed care dominating the health care industry, there is growing anxiety among Americans about its negative effects. As a result, the industry is undergoing close scrutiny. Consumer groups and state medical societies claim that managed care organizations (MCOs) are "putting profits ahead of patients" and are demanding consumer protection. In recent months, more than 500 managed care bills have been introduced at the state and federal levels. State legislation passed this year has already targeted postpartum hospital stays, emergency care, direct access to specialty care and gag clauses. -(Managed Health Care, 9/96, p.30 : Business & Health, 8/96, p. 26)

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Ask Your Chiropractic Questions On the Internet!

You can join discussions and ask questions of your colleagues on the Internet! More information can be found at http://www.chiro.org/chat/

Indicate your ACCC membership on your posts so fellow ACCC members might respond. Most ACCC members post on the Chirosci-list.

Health Cost For Mid-Sized Firms Held In Check.

Mid-sized employers held health care cost increases to just 1.6 percent in 1995, largely by continuing to switch to managed care, according to a new Johnson and Higgins report. For the second straight year, benefit costs for companies with fewer than 1,000 employees rose more slowly than the medical Consumer Price Index- even as the medical CPT hit a record low of 3.9 percent. Total health benefit costs for mid-sized employers averaged 3,476 per employee in 1995, up marginally from 3.421 in 1994. The cost was highest in the Midwest and Northeast and the lowest in the South and West. (Employee Benefit News, 9/1/96 p. 9)

Medical Savings Accounts To Be Offered In 1997

Medical savings accounts (MSAs) will be available to the first 750,000 eligible taxpayers from 1/1/97 to 12/31/2000 through a U.S. Treasury Department pilot program. Only workers at companies with 50 or fewer employees, the self-employed and the uninsured can participate. Through an MSA, employees can pay their health care expenses out of a special tax-exempt account while maintaining a high-deductible catastrophic policy that covers major accidents or illness. (The PPO Letter, 8/22/96, p. 1: National Underwriter, 8/12/96, p.3)

Study To Explore The Internet In Health Care

Consulting firm Ernst & Young has joined with a group of information technology organizations to sponsor a study aimed at helping the health care industry understand and capitalize on the Internet's potential. The project, titled "Health Care Cybervision: The Role of the Internet in HealthCare," will present survey findings, profile current and future industry leaders, and identify applications and possible barriers to the Internet's involvement in health care. (National Underwriter, 7/1/96, p.5)

Presidents Message

Most dreams remain a dormant fragment of our memory banks. With real effort, we can realize that which was once only part of our potential.

This newsletter is part of the current administration's vision that will take the ACCC into the 21st century. Pooling of ideas, relating and identifying mistakes, updating specialty knowledge and encouraging integrative constructive dialog will produce an organization that is ready and willing to expand. The future of this College depends on the desire and willingness of its members to actively participate and share their knowledge. Through renewing your membership, expressing your ideas, needs and wishes in any format and forwarding information for distribution, the ACCC, can return to being an organization that, you, the chiropractic QA/UR specialist can rely on. -Warren Jahn, DC, MPS

International Update: Canadian vs. US Health Spending

Canada's health care costs as a portion of GDP actually fell from 10.1% in 1993 to 9.7% in 1994. For Ontario, Canada's largest province with 10 million people, the comparable figures were 9.9% and 9.5%. Statistics Canada estimates that 1996 Canadian health spending will be 9.1% of GDP. The U.S. spent 13.7% of its GDP on health care in 1994 and it the Commerce Department projected that the costs will be over 14% for 1996.
(U.S. Dept. of Commerce, Statistics Canada).

CALL FOR ARTICLES

As Dr. Cates and I put together these newsletters, input from member's would be extremely helpful. If you come across pertinent information regarding UM, UR and QA. We would appreciate you forwarding it to one of us for future use.

Thank you - Jeanne Lapp, DC Fax (847) 945-8430 or E-mail to JLCHIRO@aol.com

Jots from Dr. Jeff

Dear Colleagues,
We’re on the Web! ... The ACCC has a test site at: http://www.ACCC-chiro.com. Stop in and take a look, and let us know what you think!

A larger permanent site is under construction. The current plans are to include ACCC information for prospective members and those interested in the services of the ACCC membership. Chiro-links, copies of the ACCC newsletters, and a directory are also to be included. Methods of online consulting support are also being reviewed.

If you have ideas or suggestions, feel free to e-mail me at: cates@essex1.com

- Jeffrey Cates, DC

Jewels from Dr. Jeanne

Dear Members,
In December I spoke with NCMIC regarding malpractice claims against doctor's doing peer-review. They estimate there are several thousand doctor's doing case reviews and only 3-4 cases pending. The doctor's most likely to be sued are those working for insurance companies. The claim usually is for fraudulent opinions or racketeering. The claimant sues saying the opinions are not based on valid information and the patient was injured because of the denial.

They suggested that each IME or paper review state at the end "that if there is further information that could affect this opinion we will review it again".

NCMIC also asked me to remind members that a rider is available for doctor's doing reviews.

- Jeanne Lapp, DC

Mark your calendar!
The ACCC convention is
September 18-20, 1997
at the Marriott in
Schaumburg, IL !

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