Documenting Quality Spine Care - and Getting Paid for It
Editorial Staff
| DIGITAL EXCLUSIVE
Blue Cross and Blue Shield of Kansas has announced a unique partnership with the Spine Institute for Quality whereby BCBSKS-contracted chiropractors who utilize the clinical data registry to submit metrics to Spine IQ regarding spine care will qualify for quality reimbursement payments. According to BCBSKS, the partnership is designed to establish benchmark performance measures that will improve patient care and documentation.
"Chiropractors provide important conservative spine care to thousands of BCBSKS members each year," said Dr. Daryl Callahan, DO, medical director for Blue Cross and Blue Shield of Kansas, the state's largest insurer. "By establishing performance measures, they will follow best practices that are even more valuable to patients and payors."
According to the insurance carrier, "The registry will help BCBSKS and its network of chiropractors better define an episode of care for treatment ... by collecting data such as date of service, pain intensity and imaging within the first 28 days of pain."
As discussed in our October 2017 issue, clinical data registries such as Spine IQ are increasingly utilized as a means to gauge clinical efficacy, cost-effectiveness and overall quality of care. Relative to the chiropractic profession in general and the BCBSKS-Spine IQ partnership in particular, data reporting via clinical data registries allows the profession to define quality as it relates to spine care and demonstrate value, leading to increased utilization and reimbursement for services.
In a landmark development, Blue Cross Blue Shield (BCBS) has reached a $2.8 billion settlement to resolve antitrust claims brought by health care providers, including chiropractors. The lawsuit accused BCBS of dividing the nation into exclusive regions and limiting competition, which resulted in lower reimbursements for providers. Although BCBS denies any wrongdoing, the company agreed to the settlement to avoid lengthy litigation – and you can get a piece of the pie.
The World Federation of Chiropractic (WFC) Board of Directors passed a “Policy on Non-Interference and Respect for National Authority” at its Q3 2024 meeting. Upon reading this, some might ask if the WFC policy is targeting the activities of the American Chiropractic Association (ACA) in providing international membership to Japanese individuals who do not hold a chiropractic degree from an accredited institution.
Part 3 of this three-part article on recogizing and diagnosing delayed-onset motor-vehicle acident (MVA) injuries in clinical practice coversspinal cord injury linked to cervical stenosis and spondylosis; alar sprain; and delayed instability. Part 1 discussed traumatic subdural hematoma, stroke due to MVA and traumatic central disc herniation; part 2 discussed traumatic Schmorl's nodes, post-concussion syndrome and posttraummatic syrinx.
