Why did United Healthcare begin to refuse to cover clinically proven chiropractic treatment for headaches?

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Image result for united healthcare logoWhy did United Healthcare begin to refuse to cover clinically proven chiropractic treatment for headaches? If you are insured by United Healthcare, you should be concerned with their newest policies concerning the treatment of headaches by chiropractors. Most patients are unaware they no longer cover chiropractors for the initial evaluation which has been in effect for over a year now.  Many doctors of chiropractic had responded by leaving their networks, while others like our office had dropped out of Oxford, since it was becoming unaffordable to treat their patients.  We had considered dropping United for the same reason but have not yet done so. An initial evaluation in most chiropractic offices requires at least a half hour or more of the doctors time and by not covering the service, it cause economic hardships on many practices.  Their switch to a global fee may work great for doctors who perform a minimal amount of work on their patients, however, for those who do rehabilitation and take on complicated cases, they have been harmed by their current policy, which singles out chiropractors from other physician categories. Recently, they decided that Chiropractic Manipulation for Headaches is unproven even though the medical evidence for chiropractic manipulation for headaches is quite convincing.  There are of course millions of chiropractic patients who will attest that chiropractic management of their headaches was very effective. As taken from the American Chiropractic Association web site "Research shows that spinal manipulation – one of the primary treatments provided by doctors of chiropractic – may be an effective treatment option for tension headaches and headaches that originate in the neck. A 2014 report in the Journal of Manipulative and Physiological Therapeutics (JMPT) found that interventions commonly used in chiropractic care improved outcomes for the treatment of acute and chronic neck pain and increased benefit was shown in several instances where a multimodal approach to neck pain had been used1. Also, a 2011 JMPT study found that chiropractic care, including spinal manipulation, improves migraine and cervicogenic headaches2.  "  You can read more by visiting this page. REFERENCES: 1. Bryans R, Descarreaux M, Duranleau M, et al. Evidence based guidelines for the chiropractic treatment of adults with neck pain. J Manipulative Physiol Ther 2014; 37: 42-63. 2. Bryans R, Descarreaux M, Duranleau M, et al. Evidence based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther 2011; 34: 274-89. United Healthcare has been approached the ACA since their new rule ignores research that has been done over the years.  According to the ACA
UnitedHealthcare (UHC) recently issued a new policy denying coverage of spinal manipulative therapy (SMT) for headache. UHC claims that SMT as applied to the treatment of headache is "unproven or not medically necessary." ACA is preparing a response in which it calls the policy "flawed" because UHC failed to include key studies in an analysis conducted in advance of its determination. ACA is also rallying support for the withdrawal of the policy from chiropractic organizations across the country. Look for more information in next week's ACA Connects.
If you have a choice of which insurance you can be insured with under your employer, you may wish to consider these policies especially since it effects the quality of the care you can receive, the quality of the doctors you can choose and the choices that are being limited by policies such as these.  You can read about the new policy by clicking on this link. While it is important for healthcare to be scientifically based, it is also important for insurers to pay for services that are proven to work and be effective.   Often, headaches are caused by problems in the lower body causing asymmetry which causes tension in the neck.  This same phenomenon can cause vertigo in many cases as well. Many patients have found that the chiropractic approach to headaches is more effective and safer than medications or other physical medicine approaches to care. I am sure that United Healthcare will consider the ACA's position on headache care as delivered by manipulation from a chiropractor.  This type of policy is short sighted and puts profits before patients, leaving you, the consumer to pick up the tab for what should be a covered service.  The policy may also result in fewer chiropractors taking insurance issued by United, while United is also experiencing record profits. One would question who they are doing this for; to protect the public or to increase their profits further as they refuse to cover medically necessary care?