Making the Business Case for On-Site Chiropractic at Corporations

As the popularity grows for on-site solutions for the continual deterioration of employee health, there remain considerable hurdles in securing on-site chiropractic agreements with corporations. The first hurdle is the myriad of wellness-based companies vying for the corporation’s budget dollars. Corporate wellness has many faces and can include anything from health screenings of blood pressure, cholesterol, to fitness centers on-site, and online wellness portals. In this morose of offerings, how does on-site care rise above the rest and gain traction within the corporate arena?

If you leap over this first hurdle, the next hurdle is the company choosing Chiropractic as an on-site option. I have had many discussions with companies who have said Chiropractic was not something they were considering, and instead implemented massage, physical therapy or primary care services. It is frustrating, but the reality and being prepared for it will better serve you.

If you have successfully cleared that second hurdle, how do you make the business case to the company to pay you directly for your services? If the company isn’t willing to directly compensate for your services, are there enough employees on-site and are you in-network with their insurance to justify you billing insurance and collecting the co-pay from the employee?

There are many variables to consider when discussing on-site chiropractic care, and that is why we always utilize our On-Site Company Audit to determine a win-win scenario. In this article, I will attempt to make the best business case for why companies should be willing to directly compensate chiropractors for on-site services.

Why are companies concerned about healthcare and why employees should too?

As the Figure below reveals, Health Insurance Premiums and Worker’s Contributions to those premiums are skyrocketing, whereas the Worker’s Earnings and Overall Inflation are considerably lower. From 1999-2013, Health Insurance Premiums have increased 196% and Worker’s Contribution 182%. Compared to 50% and 40%, Worker’s Earnings and Overall Inflation respectively have not kept pace.  This is not only costing the employer considerably more but also the individual employee. This is a staggering inequity!


As you can see in the next figure below, Reducing Healthcare or Insurance Premium costs is the number 1 priority for companies in the United States. How can they achieve this? That is the holy grail.


Key Takeaway #1: Reducing Healthcare Costs and Health Insurance Premiums is vital to the corporation’s bottom line and a key focus of their cost saving efforts.

What are the real costs of an unhealthy workforce?

In the next two figures that follow, This particular study reveals the cost for certain conditions per Full-Time Equivalents (FTEs) employees. The first graph takes into consideration Medical, and Pharmaceutical costs annually for individuals with these conditions. As you can see, Back/Neck and Other Chronic Pain are number 2 and 3 costliest conditions. In the follow-up graph, figure 4, when Absenteeism and Presenteeism are factored in, the costs for these conditions increase considerably. Absenteeism is when an employee misses work due to health-related issues. Presenteeism is when the employee is physically at work, but due to the effects of health conditions, are not performing optimally, and therefore their work isn’t to standard.


Sadly enough, poor health is costing employers $576 billion a year. 40% on Medical and Pharmacy, 40% on Lost Productivity, and 20% on Wage Replacement. Don’t you think we are Chiropractors could reduce these numbers?


Key Takeaway #2: Back, Neck and Other Chronic Conditions are top cost conditions that employees are suffering from and it costs $576 Billion per year.

What is the top cost category of medical expense distribution?

Below in the 2011 OptumHealth Client Data study, they found that the treatment of orthopedic conditions is the top cost category coming it at 17% of medical expenses. This study now positions musculoskeletal conditions as the largest cost to OptumHealth’s insured. Being able to mitigate these orthopedic costs will be instrumental in reducing health insurance costs and premiums.


Key Takeaway #3: Orthopedic/Musculoskeletal conditions are the highest distribution of medical expenses based on OptumHealth Client data of 2011.


Distribution of Orthopedic Expense


In the same 2011 OptumHealth study, it revealed that spinal care is the top orthopedic expense and 80% of those spine related conditions are non-surgical. Keep these two points in mind as you read on further.


Key Takeaway #4: Spine Care is the largest musculoskeletal condition cost, and 80% of those conditions are non-surgical conditions. Non-surgical spine conditions are the bread and butter of Chiropractic care.



What is the ROI of an Effective Workplace Wellness Program?

From the Harvard Business Review, December 2010: What’s the Hard Return on Employee Wellness Programs? The Date shows that the ROI on a comprehensive, well-run employee wellness program can be as high as 6 to 1.

In this same study, it laid out the 6 Pillars to achieve this 6 to 1 Return On Investment. If you are going to obtain an On-Site Chiropractic clinic, you will want to make sure the program you are offering is collaborative with the company and the 6 Pillars are implemented. Otherwise, the ROI of your on-site care may not be realized.


Key Takeaway #5: Harvard Business Review Study reveals a 6:1 Return On Investment with an Effective Workplace Wellness Program

Making the case for Chiropractic Care as the First Encounter


Data from OptumHealth indicate that a more efficient treatment path typically begins with a patient consulting a Chiropractor. This path tends to lead to interventions that are more closely aligned with recommended treatment guidelines and ultimately more favorable solutions at more reasonable costs.

Similar findings can be found in a two-year retrospective claims analysis of Blue Cross Blue Shield-Tennessee members. It found that “Paid costs for episodes of care initiated with a doctor of chiropractic medicine were almost 40% less than episodes initiated with a medical doctor. Even after risk adjusting each patient’s cost, we found that episodes of care initiated with a DC were 20% less expensive than episodes initiated with an MD.


Key Takeaway #6: Chiropractic is the most effective and affordable option for musculoskeletal conditions.

Making the business case for On-Site Chiropractic Care

The Growing Role of Doctors of Chiropractic in On-Site Corporate Health Clinics published by Foundation for Chiropractic Progress.

"Doctors of Chiropractic (DC) are well trained and positioned as the first option for drug-free, non-invasive, evidence-based and effective back and general neuro-musculoskeletal pain management. In fact, findings publish in a 2012 issue of the Journal of Occupational and Environmental Medicine suggest that chiropractic services offered at on-site corporate health clinics, versus off-site physical therapy, might promote lower utilization of certain costly health care services while improving neuro-musculoskeletal function. Additionally, chiropractic patients often have a more conservative, less invasive treatment profile, which can significantly reduce the overall cost of treatment."


Obviously, it is better for the corporation to pay you directly for your on-site services. It not only compensates you fairly, but it also removes the financial barrier for the employee and therefore utilization will increase. With increased utilization of chiropractic care, without the utilization of the health insurance plan, the Return On Investment will increase for the employer. This should increase the health of the workforce, and allow the company to negotiate lower premiums since they have a healthier employee base that uses health insurance less. That is the secret sauce of direct-paid on-site Chiropractic care.

If the only option the company is giving you is to utilize the employee’s health insurance, and there is decent coverage, then the company will still realize a huge benefit because now the employees are spending fewer insurance dollars by seeking Chiropractic care instead of more costlier and less effective methods of treatment.

Another factor to keep in mind, and I could write a whole article on this subject alone so I will just touch on it here. Many corporations are choosing to be Self-Insured. That simply means that they pay the health care bills for their employees. The still have an insurance plan related, but instead of paying a set premium to the insurance company, they just pay the cost of the services the employees accrue. This is a prime reason why self-insured companies would greatly benefit from on-site chiropractic. The ability to control the costs and decreased Orthopedic and hospital visits would significantly reduce theirs out of pocket costs.

Key Takeaway #7: Direct-Paid On-Site Chiropractic Care Increases Employee Utilization and Potentially Increases the ROI for the Corporation.

To summarize, to build your business case for On-Site Chiropractic Care you need to compel the company to grasp the benefits by taking them down this pathway of research that supports your case. These 7 Takeaways will help you build a convincing presentation for your services.