The patient population continues to move toward "alternative" health care. Managed care organizations (MCOs), including health maintenance organizations (HMOs), the vanguard of managed care, are becoming increasingly aware of this trend and responding by adding additional forms of health care to their medical base of benefits.
Landmark Healthcare, Inc., a 12-year-old California-based managed care organization with networks in Arizona, California, Colorado, New Mexico and Texas, has released the final results of their 1996 survey of HMO marketing and medical directors. The survey was conducted by Sherilyn Chow, of Landmark's media and public relations staff.
"There is a significant lack of information concerning health plans' opinions about alternative therapies," noted Ms. Chow. "We wanted to know what the HMOs were doing and what they were planning. This information shows just how important alternative therapies are becoming to HMOs. As an alternative managed care company this survey clearly demonstrates that our company is in step with the alternative health care trend."
Landmark surveyed 156 HMOs in the 13 states where more than 10 percent of the population is enrolled in an HMO. The following are the HMO penetration rates for each state where the survey was conducted:
| Arizona | 30.4% |
| California | 38.4% |
| Colorado | 34.7% |
| Connecticut | 21.0% |
| Massachusetts | 42.1% |
| Nevada | 16.7% |
| New Jersey | 22.9% |
| New Mexico | 18.6% |
| New York | 26.1% |
| Oregon | 34.9% |
| Texas | 14.6% |
| Utah | 21.2% |
| Washington | 24.9% |
Even though only 80 (51%) of the HMO directors responded, the results of the survey leave little doubt that "alternative" care is on the rise.
Alternative Trend
The results of three survey questions reveal what HMO members are asking for:
HMOs that currently offer alternative care therapies:
Yes = 42.50%
No = 57.50%
HMOs' future plans to offer alternative therapies:
Yes = 57.50%
No = 41.25%
No Response = 1.25%
Members' demand for alternative care therapies:
Yes = 70.00%
No = 27.50%
Blank = 2.50%
Decisions, Decisions
There are several factors that will influence the decision by managed care organizations to add chiropractic care and other forms of care. The most obvious is the impact on enrollment.
Alignment of alternative therapies with HMOs' cost-containment strategies:
Yes = 41.25%
No = 50.00%
No Response = 8.75%
HMO members' knowledge of alternative therapies:
Somewhat = 71.25%
Not at all = 23.75%
Very = 5.00%
Impact o alternative therapies on HMO enrollment:
Increase = 37.97%
Significant Increase = 1.27%
No Impact = 48.10%
Would Not Add therapies = 10.13%
No Response = 2.53%
Chiropractic is obviously making substantial inroads into HMO delivery systems, and leading the way in patient demand. Based on the survey findings, it is interesting to see that chiropractic appears to be more mainstream i.e., not considered "alternative" by 52% of the HMO respondents.
The take-home-message here is simple. Patient appreciation of the benefits of chiropractic care will fuel patient demand. Patient demand, coupled with the ability of DCs to function effectively in the HMO environment, will impact HMO enrollment and ultimately chiropractic inclusion into every HMO in the U.S.
