Maternal Mortality Rates and How Race is a Factor

While we may be hearing about it more lately, the maternal and fetal mortality rate in the black community is NOT a new issue. As a whole, the US has a higher maternal mortality rate than most other high-income countries. Now I want you to think about this… African American women (across the income spectrum and from all walks of life) are dying from preventable pregnancy-related complications at three to four times the rate of white women in the US! Severe maternal morbidity affects pregnant women across the board, but these severe life-threatening pregnancy-related complications (known as SMM) affect twice as many black women as they do non-Hispanic white women. African Americans have the highest infant mortality rate of any race in the United States which can be tied to pre-term births. The death rate for black infants is twice that of infants born to white mothers. [1]

Why is this the case?

Deeply-rooted structural racism in the healthcare service delivery plays a big role in these devastating outcomes. Receiving poorer quality care, as well as limited access to maternal care, results in increased levels of pain and stress which has massive physiological effects on the pregnant mom’s physical and mental well-being. These stress-induced physiological changes make black pregnant women more susceptible to conditions such as pre-eclampsia, eclampsia, embolisms, and mental health issues, threatening the mother-to-be’s life and her child’s as well. 

What can be done to create change?

1. Improve access to quality care. Often times counties have what are known as maternity care deserts, where access to maternity health care is either extremely limited or completely absent. This limited access can be a result of a physical lack of care or an inability for a woman to utilize it. These “deserts” occur in rural areas, but can also exist in urban areas when hospital obstetric units close in and around cities. [2] Below is a map, from 2016, that shows the different levels of access to care throughout the United States. The red on the map indicates counties where there are zero hospitals and zero OB/midwife providers. If public transportation is limited, many pregnant women in these counties are unable to get the appropriate maternal care and even if public transportation is accessible, this places strain on surrounding obstetric facilities and can hinder the quality of care provided. Strengthening the systems that are already in place, as well as providing African American women tools to utilize the the maternity health care system is essential.

2. Improve the quality of care provided to pregnant women. As one of the wealthiest countries in the world, the United States could and should be doing better (in my humble opinion) when it comes to maternal and infant mortality! Programs in which providers are trained to address racism and build a more diverse workforce have an enormous impact on the quality of maternal care for black women and other women of color. Accessibility of screenings and standardized assessments also allow for the prevention and/or prompt treatment of maternal and fetal health issues. 

3. Enhance support for families before and after birth. Community is essential during the prenatal and postnatal period. Resources such as birth education and doulas are pivotal in increasing support as well as improving birth outcomes. As a pregnant mother’s advocate, doulas can be instrumental in making sure moms are getting appropriate screenings and quality maternal care. Doulas also provide postnatal support and are in a position to make sure baby is receiving appropriate testing and care. 

What Can You Do?

You may be reading all of these alarming facts and thinking “This is horrible, but what am I supposed to do about it?” I found myself in that exact same place. I recently read the book “Untamed” by Glennon Doyle and in one specific chapter she talks about becoming a philanthropist. In this chapter, Glennon shares a quote from Archbishop Desmond Tutu that hasn’t left me, “There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.” This brings up two immediate questions, one how can I help black mothers-to-be right now? And two, how can I help stop the root cause of the issue? 

So here’s what I’ve come up with for a starting point. The Natural Way Birthing Project, located here in Fort Worth TX is a non-profit run by a black female and doula, named Nikia. The mission of the project is “to help lower infant mortality risk factors and nurture participating families through education, advocacy, and support during pregnancy and beyond.” The goal of Natural Way Birthing Project is to assist in educating, empowering and navigating resources for project participants and expectant families in the city of Fort Worth and surrounding Tarrant County. [3] Through the support of donors who want to see a change, Nikia has been able to provide 12 full scholarships and 15 partial scholarships for membership and training of birth educators and doulas, as well as provide each participant with a manual. She is also able to provide a free birth education class to expectant moms and their support person once a month. To learn more about this class click here. 

I’ve decided to hold a day in the office, once a quarter, where all collections will go directly to The Natural Way Birthing Project! The first date for this year will be on August 8th, 2020. If you’d like to contribute to a cause where they are pulling people out of the river and also looking upstream, please join us! If you’re unable to come in to the office on August 8th, but feel lead to donate, we would love and appreciate that support as well!

If you don’t live in the DFW area and would like to contribute at more local level for your community, please check out Birthing Project USA to find a project near you. I am beyond excited to support these volunteers who are the hands and feet in our community and are truly doing the work. 

“We must become the change we want to see in the world.” ~ Mahatma Gandhi

Resouces

1) (May 2, 2019) Eliminating Racial Disparities in Maternal and Infant Mortality. Retrieved June 24, 2020. https://www.americanprogress.org/issues/women/reports/2019/05/02/469186/eliminating-racial-disparities-maternal-infant-mortality/

2) (2018) Nowhere to go: Maternity Care Deserts Across the US. Retrieved June 24, 2020. https://www.marchofdimes.org/materials/Nowhere_to_Go_Final.pdf

3) Retrieved June 25, 2020. http://thenaturalwaybp.org

Is CBD For Me?

Stress and anxiety levels are higher than ever which has lead to me getting asked, on a regular basis, what my thoughts are about my thoughts regarding CBD… Does it work? Is it safe? What else can they take? In today’s blog post I will be addressing some of these questions and getting a little geeky about cannabis! 

Wait, there’s an actual system in the body specific to cannabinoids?

Endocannabinoids and their receptors are found throughout the human body including the brain, immune cells, connective tissue, organs and glands. The endogenous cannabinoid system was named after the plant, cannabis, which led to its discovery. [1] This system has a strong impact on the immune system and nervous system and therefore is extremely influential in the connection between the mind and the body. 

The medicinal use of cannabis has been around and used medicinally for centuries. The first recorded use occurred around 2727 BC, when Emperor Sheng Neng of China used a cannabis-based tea to help with a variety of health ailments that included poor memory, malaria, and gout. [2] 

It wasn’t until 1940 that a research team discovered that active compounds could be derived from a cannabis plant that did not have psychotropic effects that were typically associated with the plant. This is where cannabidiol (or CBD) came from.  

Can I test positive on a drug test from taking CBD?

In December 2018 CBD became legal on the federal level and has since become all the rage. A majority of CBD products are produced from hemp, but sometimes they are produced from marijuana plants which can result in the product containing THC (the psychotropic compound). Since marijuana is only legal in 10 states and Washington D.C., if you aren’t certain of where a CBD product is sourced from, this can pose a problem, depending on where you live. [3] It can also be problematic for people who are drug-tested for work if they are taking a CBD product that was sourced from a marijuana plant rather than hemp. In addition to the potential presence of THC, the process in which CBD is derived from the cannabis plant results in impurities and inconsistencies of the concentration of actual active compound present. For some professionals, the risk simply isn’t worth it, even if the results are there.

Does CBD work?

Since the legalization of CBD, it has become extremely popular and is said to help with a wide variety of conditions that include chronic pain and inflammation, anxiety, epilepsy, sleep and insomnia, ADHD, arthritis, depression, and fibromyalgia… all by impacting the endogenous cannabinoid system. Some patients report that a significant improvement in sleep, anxiety, or pain when they use CBD, other patients reported no changes at all. Every human body is different and not everyone responds the same way!

Is there something else I could take?

What if I told you there are other ways to affect the cannabinoid system that did not pose a risk for consumption of THC, had a controlled concentration of endocannabinoid compound, and was pure? Well guess what… there are! The essential oil, Copaiba, is derived from the resin of the Copaiba tree found in South America. [4] Where CBD indirectly stimulates the cannabinoid receptors in the body, reliant on a chain of activities occurring, Copaiba actually directly activates the receptors! [5] It can be used topically or ingested, just like CBD, but doesn’t come with the risks of THC or other unnecessary impurities. In addition to this, Copaiba is way more cost effective!

Now, more than ever, we are seeing an increasing number people suffering from anxiety, chronic stress and inflammation. At the same time, we are learning more and more about the implications of long-term use of commonly recommended medications for these conditions. It is imperative that we continue to find more natural solutions to assist our bodies as we address the root cause of these different issues! 

If you have been apprehensive to try CBD, found it doesn’t help you, or would simply like to try something that is more regulated and cost-effective, I can’t recommend Copaiba enough. With that being said, I can’t emphasize enough the importance of where the Copaiba essential oil is coming from. Some companies add fillers or other constituents that result in their essential oils being impure and therefore not therapeutic grade. DoTERRA performs extensive third-party testing for adulteration and contamination as well uses sustainable and responsible sourcing and therefore is the only company I will use. 

Want to get your hands on some Copaiba?

There are a couple of different options to consider! There is the pure essential oil that can be applied topically or taken orally or there are soft gels that can be ingested, just like any other supplement. Benefits include decrease in anxious feelings, decreased inflammation, decreased pain, improved sleep, improved immunity and improved general well-being. Click the links above to order either of these products online or to simply read more about them.

As with anything in our office, we do not recommend it unless we have taken it ourselves or would give it to a family member! If you have questions or would like to learn more, please don’t hesitate to reach out or ask at your next appointment.

Resources:

1. (November 1, 2013) Getting High on the Endocannabinoid System. Retrieved June 15, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997295/

2. (March 8, 2019) The History of CBD: A Brief Overview. Retrieved June 18, 2020. https:// medium.com/cbd-origin/the-history-of-cbd-a-brief-overview-68545c05ccc9

3. (January 13, 2020) Is CBD Legal In Your State? Retrieved June 16, 2020. https://www.cbdoil.org/cbd-laws-by-state/

4. Retrieved June 16, 2020. https://www.doterra.com/US/en/p/copaiba-oil

5. CBD Vs. Copaiba. Retrieved June 15, 2020. https://www.doterra.com/US/en/podcast-episode-19-cbd-vs-copaiba

6 Things You Can Do Today To Mitigate Stress

Stress… now more than ever it’s a hot topic. At this point, I think most people know that too much stress is harmful to our health. Our bodies were never designed to be in a chronically stressed state. The purpose of the stress hormone, cortisol, is to help us survive in life-or-death scenarios, such as being chased by a grizzly bear or escaping a burning building. Most people are not facing these types of situations on a regular basis, but unfortunately our minds are not able to decipher the difference between past-due bills and being pursued by a lion. 

According to a survey done by the American Psychological Association, three out of four Americans report experiencing at least one stress symptom in the last month. 45 percent report lying awake at night, 36 percent report feeling nervous or anxious, 35 percent report irritability or anger, and 34 percent report fatigue due to stress. [1] The most commonly perceived stressors included money, work, economy and relationships. With the current Covid-19 situation, I can only imagine that all of these have become even more prevalent. With each of these circumstances, our adrenal glands pump out cortisol, which is beneficial in small windows, but not on a continual daily basis. 

Studies have shown that there are over 150 diseases associated with cortisol. Some of these conditions include immune senescence (decreased immune function) with age, biological aging, insulin resistance, metabolic syndrome, decreased testosterone in men and decrease in pain threshold. 

Often times I find that we hear about statistics or data regarding health issues, but that doesn’t really provide us with a solution or even hope of finding a solution. I want to break the process down a bit in hopes that we can simplify the problem as well as the solution!

How does cortisol affect testosterone and what does that have to do with a decrease in pain threshold?

When in excess and/or present for longer than normal, cortisol essentially stops the first step of testosterone production in the Leydig cells of a male. This decrease in production results in low testosterone levels in the body which increases the responsiveness of nociceptors to stimulation. Basically what this means is that the receptors in the body that are designed to sense pain become hyper-sensitive and over-react, resulting in decreased pain tolerance or increased pain perception. So we have men walking around who are stressed out, suffering from low testosterone, and chronically in pain. 

What is biological aging and how does stress cause this?

Chronological age is the number of years you have been alive… pretty straight forward. Biological age is a bit more complex and is based on a number of factors. Biological aging occurs as cells and tissues gradually become damaged and is a result of chronological age as well as lifestyle, nutrition, genetics, diseases and other conditions. [2] 

Cortisol has been associated with oxidative damage and mitochondrial dysfunction. What’s significant about mitochondria is that they are the energy producers of our cells… without this energy the cells cannot operate optimally and that results in cell damage, which results in biological aging. 

So what can we do about all of this? Covid-19 isn’t going to simply evaporate into thin air and those bills are going to keep coming.

Here are six things we can all do to mitigate stress and the symptoms that come along with it. 

1) Focus on what you CAN control. There are plenty of things in this world that are beyond our control and when those things are what consume our thoughts… guess what? We get stressed! So instead, pour your energy into the aspects of your life that you can control. For example, I can control the effort I put into my job and really every activity I do. I can control my thoughts and my attitude towards others. I can control the foods I put in my body.

2) Get Adjusted. A study was performed in which a specific brain response was measured in twelve men, before and after a chiropractic adjustment of the neck. The results suggested that the chiropractic adjustment affected sympathetic (fight or flight) relaxation and pain reduction. [3]

3) Exercise. High intensity interval training (HIIT) for as little as 10 minutes is an excellent stress reset. This can be as simple alternating between walking and jogging or doing a tabata workout. For a few examples, check out this article. 

4) Meditation. Meditation is extremely beneficial in stimulating our vagus nerve, which is a very important aspect of our parasympathetic (rest and digest) nervous system. In as little as 5 minutes, meditation can decrease that fight or flight response and increase the rest and digest. Simply search “meditation” on youtube and you’ll have access to hundreds of guided meditations. You can also subscribe to apps such as Calm or Peloton. 

5) Yoga. Not only is yoga great because we are exercising and moving our bodies, but we are also focusing on our breath! If flexibility isn’t your strong suit, no need to be intimidated, there are yoga practices for all types. Yin yoga is a great practice to get a deep stretch as well as some deep breathing and serious relaxation. Many yoga studios are offering virtual classes or you can find plenty of options on youtube or the Peloton app. 

6) Nutritional support in the form of phosphatidylserine. This supplement has been found to support health mitochondrial, mitigate cortisol, and reduce the effect of serum-cortisol. If you’re not sure where to find phosphatidylserine, don’t hesitate to contact us!

With more and more Americans being diagnosed with diabetes and Low T clinics popping up all over the place, the issue of stress cannot be ignored. While the stressors may not be changing, our response absolutely can! We each have the power to choose what we put in our bodies and the activities we implement into our daily routine. 

Resources

1) (December, 2017) By the numbers: Our stressed-out nation. Retrieved on May 9, 2020. https://www.apa.org/monitor/2017/12/numbers

2) Chronological Aging and Biological Aging. Retrieved on May 9, 2020. https://www.healthline.com/health/chronological-ageing#biological-aging

3) (November-December, 2017) Cerebral metabolic changes in men after chiropractic spinal manipulation for neck pain. Retrieved on May 11, 2020. https://www.ncbi.nlm.nih.gov/pubmed/22314714

Confusion Amidst the Corona Virus

Have you lost track of the day, date, month or even time of day? Well you are certainly not alone in that! Besides general whereabouts in time, the shelter in place order in Texas has lead to a lot of confusion amongst patients… are we closed? Are we open? What qualifies as a “medically necessary” visit? In today’s blog post I hope to provide some clarity around these questions, as well as a few helpful tips and reminders!

1) Are we open?

Yes! We are maintaining normal business hours in all of our locations while taking a few extra precautions to keep our patients health, safe and comfortable. The adjusting table, ipad, door handles and all other surfaces are being wiped off with disinfectant between EVERY patient. We have spaced out our scheduling, implementing a 15 minute gap between appointments, to allow for everything to be wiped down and proper social distancing. We are also asking any patients who are experiencing symptoms or have been exposed to someone experiencing symptoms to notify us so that they can get rescheduled.

2) What qualifies as a “medically necessary” visit? 

Chiropractors are considered essential healthcare workers. Because we are a primary care physician who can evaluate and diagnose patients with musculoskeletal conditions, it is important that we are able to continue providing our services. This helps to keep people out of urgent care and emergency rooms for issues such as neck pain, back pain, and headaches, which prevents unnecessary exposure and removes strain from the medical system. This also allows healthcare providers who are working tirelessly to receive the care they may require in order to continue doing their jobs without pain or disability. 

With all of that being said, The Texas State Board of Chiropractic Examiners has recommended that licensees should only provide essential chiropractic services for patients with current or recurrent complaints of pain or disability which adversely affects the patient’s ability to engage in the essential activities of daily living or work, or adversely affects the patient’s quality of life, and with anticipation of material improvement under chiropractic care. [1] So basically, if a complaint is affecting your normal daily activities/work or impacting your quality of life… you can come get adjusted!

3) What are the most common complaints we are seeing right now?

Neck and Upper Back Pain: 

With a majority of people working from home we are seeing a slight shift in symptoms. On multiple occasions I have had patients share that they are mixing up their work setup by rotating from the bed, to the sofa, to the desk, to the kitchen table, to the patio. With some of these less than ideal setups, many people are starting to experience tightness and pain in their mid to upper backs and necks. For a few workstation do’s and don’ts be sure to follow us on Instagram and on Facebook.

Low back pain and hip tightness: 

Over the past few years, many people have upgraded their workplace desks to a standing desk and are missing it dearly while quarantined at home. With more sitting comes shortening and tightness of the hip flexors and muscles supporting the low back and core. Tightness and shortening of these muscles can lead to low back pain and hip pain. Taking quick breaks every thirty minutes to walk around or standing up while on a conference call, as well as stretching, are some quick fixes, but if that’s not doing the trick, we are here for you!

Head and Neck Tension:

For pretty much every human being, Covid-19 has brought about new stresses. Parents are now juggling a 40 hour work week, homeschooling, and daycare. Business owners are trying to adapt and overcome changes to their operations. People are taking pay cuts or losing their positions all together. With increased stress comes increased muscle tension. According to  the American Psychological Association, both tension-type headache and migraine headache are associated with chronic muscle tension in the area of the shoulders, neck and head. [2] Breathing exercises and meditation can be extremely helpful in stress reduction (click here for some quick tips), but it may require a more hands-on approach and that’s where an adjustment and soft tissue work comes in. 

4) What if I’m not comfortable with coming into the office for an appointment?

We’ve got your back (literally)! While I can’t perform an adjustment over the phone or video conference, I can certainly find out more regarding your symptoms and situation. After getting a general idea of what is going on, I can make recommendations of specific things you can do at home to help reduce symptoms and improve function. This can include a combination of stretches, exercises, ergonomic modifications, and/or supplements that might support whatever your situation may be. A  

The software system we use has a HIPAA-compliant video-conferencing application built-in so you can rest assured that your appointment is secure and private. We are even offering a discounted rate for teleconferencing right now. Normally $50, a virtual new patient visit is $40 and existing patient visit is $20 (normally $35). 

While I know this is a difficult time, I hope that you’re finding the positive in it as well. A question/reminder I continue to offer myself is “What is something you are going to miss once we’re no longer in the middle of a pandemic? Go do more of that while being grateful and present in the process!” For me that’s been planting herbs and veggies on my patio, reading, hot baths, meditation, working out, refreshing my Spanish skills, and extra walks with my pup, Rocky. 

If there is anything we can do to make life a little bit easier, please don’t hesitate to reach out! 

Here for you always.

Dr. Nikki 

Resources

1) (2020, April 13) UPDATE: Recommended Guidelines for DCs During COVID-19 Pandemic. Retrieved April 15, 2020. https://www.tbce.state.tx.us

2) Stress Effects on the Body. Retrieved April 16, 2020. https://www.apa.org/helpcenter/stress-body

Four Tips to Boost Your Immune System and Overall Health

I don’t know about you, but my inbox has never been so full of emails on one topic! The bombardment of information regarding COVID-19 may be leading to feelings of overwhelm and fear. You may be wondering whether you should be concerned. You may also be wondering what you can do to keep you and your family healthy during this seemingly turbulent time. The specifics of the epidemiological nature of this disease are unknown. What we do know, based on the data available so far, is that this virus does not seem to be seriously impacting children or pregnant women. We also know that  if you have healthy, strong immune system you are much less likely to be significantly impacted by the virus. 

So besides hand washing and using hand sanitizer with at least 60%, alcohol what else can you do to stay healthy? Here are four tips to support your immune system and overall health. 

1) Get enough sleep and do it consistently 

Studies have shown that sleep and circadian rhythm play an integral role in the regulation of our immune system and well as enhancing our natural defense system. Research actually showed that the greatest immune response takes place while we are sleeping. [1] So rest up!

Developing a consistent bedtime routine as well as going to bed and waking up around the same time each day are extremely helpful in getting the most out of your sleep. Limiting your screen time for 1-2 hours before bed and/or utilizing blue light glasses has been shown to support your body in naturally producing melatonin at the appropriate time so that when you lay down to go to bed, you’re able to fall asleep more easily. My favorite way to keep track of my sleep and recovery is with my Whoop.

2)  Manage your stress levels and have a healthy mindset 

An overload of alarming news reports and talk among coworkers, friends and family members about the Coronavirus may be adding to all of the other stressors you’ve already been encountering on a daily basis. 

    - Simple breathing exercises can be done to help bring down stress levels immediately.  Check out these breathing exercises you can do anywhere, anytime. 

    - Meditation is also a great way to reduce stress levels. There are a number of meditation apps as well as youtube videos if you’re not sure how to get started.

  - Hug the people you love. That’s right, you read that correctly. In a time where we’re being filled with the fear of human contact, I’m going to go against the grain and encourage it (using good judgment of course). A study conducted by Carnegie Mellon University found that more frequent hugs protected people from the increased susceptibility to infection associated with being stressed and resulted in less severe illness symptoms. [2] 

3)  Take your supplements 

I have a few favorites that are great to add into your daily routine when you’re either feeling a bit under the weather or around other people who are. 

     - Vitamin D: Luckily we’re starting to have nicer weather in Texas, but that sun exposure may not be enough Vitamin D to give your immune system the boost it needs. Vitamin D is a fat soluble vitamin, so to best absorb it, you want to take with a meal that contains a good amount of healthy fats like avocado or nuts. Not sure what Vitamin D supplement would be best for you? Feel free to give us a call and we can help you!

     - Elderberry: Teas and syrups made from this plant have been used to boost immunity and fight upper respiratory infections for hundreds of years. Loaded with antioxidants, elderberry syrup been shown to decrease the duration and severity of cold and flu symptoms. [3] You can purchase elderberry syrup at your local health food store or you can make your own using a recipe such as this one. An important note, pregnant or nursing mamas should avoid taking elderberry. 

      - OnGuard or DDR Prime: DoTERRA is doing an incredible job of keeping up-to-date with current statistics and research as we learn more about Coronavirus. While OnGuard is currently sold out, if you already have it, it’s a great tool to use! These two supplements are jam-packed with essential oils that have been shown to increase immunity as well as help fight-off bacteria and viruses. Not sure how to get your hands on these products? Click here. 

4) Continue to get adjusted

While most people think of back pain when they hear the word “adjusted”, it helps with SO much more! When we make adjustments of the spine, we are actually affecting the function of the nervous system, which has a direct effect on the immune system. Studies have shown that messenger molecules called IL-2, which were are typically thought of as immune cells, are also found in the nervous system. [4] Adjustments also help to calm down the sympathetic (fight or flight) nervous system when our bodies are in a state of high stress and producing excess cortisol. Cortisol is known to inhibit the immune system, so adjustments are a great way to help keep this in check! 

We, at Renew & Restore Wellness, are taking every precaution to keep our spaces safe and clean for our patients so that you can continue to get your adjustments and stay healthy. We are wiping the table down with OnGuard cleaner between patients, washing hands and/or using OnGuard hand sanitizer between patients, wiping down children’s toys and other surfaces with every use and diffusing immune-boosting oils. Our office buildings are also taking every precaution to keep the building and restroom up to par with recommendations from the CDC. 

While I am not an infectious disease doctor, there are reliable resources who are! Check out Dr. Aviva Romm’s page for continual updates and holistic advice.

Resources

1) (2011, November 10) Sleep and immune function. Retrieved March 13, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/

2) (2014, December 17) Hugs Help Protect Against Stress and Infection, Say Carnegie Mellon Researchers. Retrieved March 12, 2020. https://www.cmu.edu/news/stories/archives/2014/december/december17_hugsprotect.html

3) (2018, November 6) Elderberry: A Natural Way to Boost Immunity During Cold and Flu Season? Retrieved March 12, 2020. https://health.clevelandclinic.org/elderberry-a-natural-way-to-boost-immunity-during-cold-and-flu-season/

4) (2015, November 30) Surprise: Chiropractors Can Treat These 5 Conditions. Retrieved March 14, 2020. https://health.usnews.com/health-news/patient-advice/articles/2015/11/30/surprise-chiropractors-can-treat-these-5-conditions

Do You Take My Insurance?

This is one of the first questions that gets asked when new patients are looking to schedule their first appointment at a healthcare providers office. Insurance has been a hot topic for years and it can be confusing and overwhelming. With a language of its own, words like “deductible”, “co-pay”, “out-of-pocket”, and “HSA” can result in the immediate glazing over of eyes. 

People pay a lot of money towards their insurance premiums, so naturally they want to utilize what they’re paying for… but is using your insurance always the most cost-effective option?

With insurance premiums continuing to increase, more and more people are switching to policies with the most affordable premium, a high deductible health plan. For 2020, the IRS defines a high deductible health plan as any plan with a deductible of at least $1,400 for an individual or $2,800 for a family. An HDHP’s total yearly out-of-pocket expenses (including deductibles, copayments, and coinsurance) can’t be more than $6,900 for an individual or $13,800 for a family [1]. A study conducted by the CDC, showed that from 2007 to 2017, enrollment in high deductible health plans with a health savings account (HSA) increased from 4.2% to 18.9% and without an HSA from 10.6% to 24.5% in adults aged 18-64 [2]. This means that while people are saving on their health insurance premiums, they’re paying much more out of pocket before insurance actually kicks in to cover anything. 

So where does your chiropractic care fit into this equation?

Some insurance companies and policies do allow for chiropractic care to be billed. Typically these policies will permit between 12-20 visits to be billed per year, based on “medical necessity”. Keep in mind, this is all based on what the insurance company deems medically necessary, not what you or your provider believe. If you have a high deductible health plan in which your policy allows chiropractic care, these visits can be billed by an in-network chiropractor. But here’s the kicker… just because those chiropractic visits are being billed to your insurance company doesn’t mean that they are the ones paying for those visits! If you have not met your high deductible (shelled out anywhere between $1400 - $6000) you will be the one paying for your chiropractic care and it is simply being applied towards your deductible. If and when that deductible is met, then your insurance company kicks in and starts paying whatever percentage of cost that has been agreed upon in your policy, which typically ranges anywhere from 50-90%. 

Speaking of paying, the insurance company also determines the exact amount that will be paid for a service. Each insurance company has a set “allowed amount” for any billing code submitted by a provider. What this means is if a chiropractic visit is being billed towards your deductible, you will be paying anywhere between $65 - $125 depending on what services were billed by the chiropractor. 

I share all of this in hopes of better explaining why, at Renew & Restore Wellness, we are not in-network with any insurance companies. Here are the three primary reasons why we don’t take your insurance:

1. We are able to pass savings along to our patients.    

    Healthcare is expensive and can have a huge impact on decisions that families have to make. A report produced by Kaiser Family Foundation found that 25 percent of workers say they or an immediate family member struggled to pay their medical bills before meeting their deductible over the last year. The report also found that 26 percent say they cut back spending on food, clothing and basic household items to pay for healthcare costs. [3] 

Billing insurance comes with additional costs for the provider as well. It typically requires additional time and/or staff to submit and process insurance claims as well as follow-up on any unpaid or unprocessed bills. 

By cutting out the middle man (insurance) and eliminating these costs, we are able to offer our services at a much more reasonable price than if we were submitting bills to insurance. To learn more about our services and pricing click here.

And even better news… that health savings account you signed up for with your high deductible health plan? You can use it to pay for your chiropractic care with us!

2. You and Dr. Nikki are the ones deciding what treatment is right for YOU.

Each patient is different and your individual situation deserves an individualized approach. Since we’re not participating with the insurance company we are not restricted by what they deem medically necessary or reasonable. This allows us to provide the absolute best care to help you meet your health goals! 

Not sure if chiropractic care is something that lines up with your health goals or concerns? Click here to read about five unexpected reasons to see a chiropractor. 

3. You can still submit your visits with us to your insurance company on your own.

Should you wish to submit your visits to your insurance company in order for it to apply towards your insurance benefits and potentially get reimbursed, we are more than happy to provide you with an itemized receipt (called a superbill) to do so! Simply send us an email or mention it at your next visit and we will send you everything you need. 

If you’re still hesitant to see us at Renew & Restore Wellness because you think it may be better to use a provider who takes your insurance, give us a call! We would be happy to help  find out your insurance benefits in order to help you make the best decision for you and your family. 

Resources

1. High Deductible Health Plans (HDHPs) & Health Savings Accounts (HSAs). Retrieved February 17, 2020, from https://www.healthcare.gov/glossary/high-deductible-health-plan/

2. (2018, August 1). High-deductible Health Plan Enrollment Among Adults Aged 18–64 With Employment-based Insurance Coverage. Retrieved February 17, 2020, from https://www.cdc.gov/nchs/products/databriefs/db317.htm

3. (2019, June 4). Report shines a harsh light on the cost of high-deductible plans to consumers. Retrieved February 18, 20202, from https://www.healthcarefinancenews.com/news/report-shines-harsh-light-cost-high-deductible-plans-consumers