ON Chiropractic
clinically effective form of treatment,
especially for [MSK] disorders that impair
mobility, work-readiness and productivity,”
Mr. Lacey said, describing his findings on
the perspectives of insurance industry
stakeholders. Mr. Lacey interviewed
a number of stakeholders, including
Benefits Consultants and Third Party
Administrators (TPAs), including key
people at organizations like Morneau
Shepell. “Overall, chiropractors are
respected professionals recognized for
their training, clinical expertise and ethical
business practices,” he reported.
A fundamental message from Mr.
Lacey’s analysis is that the sky is not falling
when it comes to chiropractors’ inclusion
in the EHB plans. “Benefits Consultants
and TPAs agree that chiropractic is an
integral and sustainable component of
employee benefits plans with a continuing
role in maintaining the health and wellbeing of productive workforces,” he said.
The profession must remain vigilant,
in order to cement and build upon the
strength of chiropractic’s reputation
among these stakeholders.
Mr. Lacey also uncovered an
interesting thread of discussion in his
conversations that links to a broader
trend of encouraging targeted wellness
support for plan members in the
workplace. Chiropractors are thought
of as contributors to overall employee
productivity and wellness. This suggests
a synergy with an observation reported
in Benefits Canada last September
that employers are moving to more
targeted health and wellness programs
with measurable results. For example,
consider a program to encourage better
posture, frequent stretching and exercise
targeted at employees whose roles
require long periods of time seated at a
computer workstation. Who better than a
chiropractor to help employers build that
program?
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Cost Containment & the
Economics of EHB Plans
R
ecently, the concept of “cost
containment” has received a great
deal of attention in the health
care sector. Government is continually
seeking to contain costs in the publicly
funded system. In auto insurance, the
scramble to reign in Ontario’s highestin-the-nation premiums is a source of
debate, friction and new regulation.
The term is used quite frequently in
relationship to EHB too. When we hear
it we often think of it as code for “profit
maximization”. In Canada, extended
health insurance is a profit-seeking
industry and there is a responsibility on
insurers to provide suitable service while
turning a profit. A notable exception to
this rule is Green Shield Canada, which is
a not-for-profit insurer.
Profit is not the only driver of EHB
plan economics, however. There are
many factors that go into EHB plan
composition and pricing. Here is a look
at the most impactful:
Utilization Trends:
How plans are being used,
individually and across the sector, is a
key economic driver. At the moment,
there are several trends at play. One is
prescription drug pricing. The increased
availability of generic medications is
helping to contain costs. The advent
of new drugs and new classes of drugs
often pushes costs up. Biologics are
an example of a new kind of drug that
has insurers concerned. Biologics are
alternatives to “chemical” drugs that
are developed from living cells. They
are more complicated to manufacture
and, thus, more costly. To make matters
worse, these complex manufacturing
standards make the creation of generic
equivalents very, very challenging.
Increasing utilization of paramedical
benefits for mental health and MSK
condition care is another current trend.
Employer Requirements:
Insurers have many stakeholders
to manage. Individual plan members,
shareholders and practitioners are
among the most important. At the top
of the food chain, though, is a small
and influential group of individuals who
are often thought of as the “client” in
the sale of EHB plans. They are known
collectively as plan sponsors or plan
managers. These are the individuals
within companies who are responsible
for the composition and administration
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