Spinal Chat with The PCA

Transforming Chiropractic Care with Chiro Health USA: An Interview with Heather

Join Mike Barb, Executive Director of PCA, as he interviews Heather from Chiro Health USA.

Discover how CHUSA (Chiro Health USA) has been a critical partner for chiropractic practices, offering a legal structure to manage fees and improve revenue. Learn about the $49 annual membership that removes financial barriers for uninsured and high-deductible patients, leading to higher patient retention and compliance. Heather also shares insights on how CHUSA supports new chiropractors, simplifies administrative burdens, and ensures legal protection for practices. Explore real success stories and the innovative resources CHUSA offers to make chiropractic care affordable and accessible.

00:00 Introduction and Welcome

00:49 What is Chiro Health USA?

01:15 Benefits of Chiro Health USA for Practices

02:28 Addressing Financial Barriers for Patients

05:21 Compliance and Legal Safeguards

06:49 Impact on Family and Long-term Care

10:06 Administrative Ease and Team Benefits

15:47 Support for New Chiropractors

21:33 Future Innovations and Integrations

23:48 Conclusion and Contact Information

Heather Simmons-Ellis:[email protected]

Chiro Health USA Website: https://www.chirohealthusa.com/providers/

PCA Website: https://pennchiro.org/

PCA Email: [email protected]

Exploring Impact Health Sharing: A Game-Changer for Chiropractic Practices

In this episode of the Pennsylvania Chiropractic Association podcast, Executive Director Mike Barba hosts Richard and Trey from Impact Health Sharing. This strategic business partnership has been assisting PCA members in transitioning from traditional insurance models to more cost-effective healthcare sharing systems. The discussion covers the benefits of Impact Health Sharing for chiropractic care, including faster payment processing, increased patient access, and reduced administrative burdens. They dive into how chiropractors can become preferred providers, leveraging Impact Health to improve practice sustainability and patient satisfaction. Highlights include easy enrollment, premium savings, and new benefits, including teletherapy. Richard and Trey emphasize the nonprofit nature of Impact Health Sharing and its commitment to keeping costs low while promoting wellness. Listeners are encouraged to learn more about becoming a preferred provider to take advantage of these opportunities.

00:00 Introduction to the Podcast

00:52 Meet Richard and Trey from Impact Health Sharing

01:55 Impact Health Sharing: Benefits and Opportunities

04:18 How to Become a Preferred Provider

09:11 Real-Life Success Stories

11:31 Educational Resources and Support

17:53 New Features and Future Plans

19:29 Final Thoughts and Closing Remarks

To learn more about Impact Health Sharing: https://www1.impacthealthsharing.com/?referral_id=02251386.

Your Exclusive Referral Code: 02251386

Use this code for PCA member exclusive benefits and pricing.

Impact Health representatives:

Richard Voelker: [email protected]

Trey Voelker: [email protected]

PCA: https://pennchiro.org/

Email the PCA: [email protected]

PCA Deep Dive: Medicare Stuck in 1972; The Case for Chiropractic Modernization

Episode Overview

This episode examines the Chiropractic Medicare Coverage Modernization Act (H.R. 539 / S. 106) and the structural limitations within Medicare that restrict coverage of chiropractic services to spinal manipulation only, excluding evaluation, imaging, and related services routinely covered for other physician types.

We explore the economic impact of referral loops, opioid exposure pathways, and downstream surgical costs, along with recent JAMA analysis on Medicare Advantage quality measurement and data fragmentation.

00:00 Why Federal Policy Matters: Medicare Modernization Act (H.R. 539 / S. 106)

01:31 The ‘Mechanic Can’t Pop the Hood’ Analogy (How Medicare Handcuffs Chiropractors)

03:19 2026 vs. 1972: The Time-Capsule Rules Still Running Medicare

03:59 Mission & Sources: Legislative Text, Cost Data, and the New JAMA Viewpoint

05:31 Back to 1972: What Medicare Actually Covers (One Service Only)

06:37 Portal-of-Entry Reality vs. Medicare Reimbursement (No Pay for Exams or Imaging)

09:28 What the Bill Really Does: Parity, Not ‘New Services’

11:14 Meet Brenda: The Referral Loop, Delays, and the Opioid ‘Prescription Pathway’ Risk

15:39 The Hidden Price of Restricted Chiropractic Access (and Why Costs Explode)

16:34 Lane Assignment: How Barriers Push Patients Toward Opioids, Injections & Surgery

17:19 Static vs Dynamic Budget Modeling: The $50 Exam That Prevents $40,000 Surgery

19:01 The Opioid & Safety Data: Lower Prescriptions, Fewer Adverse Events, Fewer Falls

22:25 If It’s a Slam Dunk, Why Hasn’t Medicare Changed? Enter the Macro View

23:29 Medicare Advantage Explained: Star Ratings, Admin Metrics & the “Illusion” of Quality

26:10 The Data Swamp: Missing Encounter Data, Invisible Networks & Fragmented Governance

28:45 How HR 539 Fixes the Feedback Loop: DCs as Physicians, Closed Data Loops & Real Outcomes

31:21 Wrap-Up + Call to Action: Align Policy With Reality and Get Organized

Chiropractic Medicare Coverage Modernization Act H.R. 539 / S. 106 (118th Congress) Amends Section 1861(r) of the Social Security Act to recognize Doctors of Chiropractic as physicians within Medicare for covered services within their state scope of practice.

Congress.gov: https://www.congress.gov

Research and Economic Data

1. Whedon JM et al. Association Between Chiropractic Use and Opioid Receipt Among Older Medicare Beneficiaries. Spine. 2020.
2. Whedon JM et al. Association Between Chiropractic Care and Use of Prescription Opioids Among Older Adults with Spinal Pain. JAMA Network Open. 2018.
3. Kazis LE et al. Increased Health Care Expenditures Associated with Opioid Initiation for Low Back Pain. Health Services Research.
4. Davis MA et al. Association Between Early Physical Therapy or Chiropractic Care and Reduced Risk of Subsequent Spine Surgery. BMJ Open.
5. Agency for Healthcare Research and Quality (AHRQ) Noninvasive Treatments for Low Back Pain: Comparative Effectiveness Review.
6. CDC Opioid Prescribing and Risk Data https://www.cdc.gov/drugoverdose

PCA Contact information:

PCA Website: https://pennchiro.org/

PCA Email: [email protected]

PCA Strategic Business Partner Highlight: Foot Levelers

In this PCA Strategic Business Partner Highlight, we sit down with Jamie Greenawalt, President of Foot Levelers, a long-time sponsor and trusted partner of the Pennsylvania Chiropractic Association.

This conversation explores how continuity of care extends beyond the adjustment table and into everyday life, particularly through sleep posture and recovery. Patients may only see their chiropractor once or twice a month, but posture, gravity, and healing occur daily. Technology-backed tools that reinforce care between visits play a critical role in improving outcomes and long-term patient engagement.

Jamie shares the clinical and historical foundation behind Foot Levelers’ custom pillow technology, including its biomechanical design, data-driven customization, and role as an extension of chiropractic care rather than a lifestyle accessory. The discussion highlights how aligning daytime support, through orthotics, with nighttime recovery, through sleep posture, creates a more complete approach to whole-body biomechanics.

The episode also addresses how strategic business partners can help practices responsibly diversify revenue, strengthen patient interactions, and support compliance without compromising clinical integrity. Education, mentorship, and evidence-informed tools are positioned as force multipliers that enhance both patient experience and practice sustainability.

This highlight underscores the value of PCA’s strategic partnerships and their role in supporting chiropractors with practical solutions, professional advocacy, and long-term practice resilience.

00:00 Introduction to PCA Strategic Business Partner Highlight

01:03 Meet Jamie Greenwalt and Foot Levelers

01:31 The Evolution of Foot Levelers' Custom Pillow

02:25 The Science Behind the Nexi Pillow

04:09 Success Stories and Patient Feedback

05:55 Integrating the Pillow into Chiropractic Care

10:20 Training and Continuing Education for Doctors

11:19 Business Benefits of Foot Levelers' Products

12:48 Final Thoughts and Call to Action

Foot Levelers': https://www.footlevelers.com/

YouTube Link: https://youtu.be/eKAG5aiii7U?si=nqBlzdliLmOvYUBi

PCA: https://pennchiro.org/

Email the PCA: [email protected]

January President’s Address Dr Andrew Heck: Momentum and Advocacy in PA Chiropractic

January President’s Address: Momentum and Advocacy in PA Chiropractic

In this episode of Spinal Chat by the Pennsylvania Chiropractic Association (PCA), the January President’s Address is delivered by PCA President Dr. Andrew Heck. The address, initially shared in the PCA newsletter, provides an overview of the significant progress in the chiropractic profession within Pennsylvania. Key topics include legislative advancements (such as House Bill 1106), ongoing advocacy efforts, insurance reform, and the conceptual introduction of 'chiropractic physicians' to better reflect their roles within the broader healthcare system. The address emphasizes the importance of chiropractor engagement, public education, and policy support to integrate chiropractic care into mainstream healthcare further.

00:00 Introduction to Spinal Chat

00:53 President's Address: Momentum in Chiropractic

01:35 The Role and Value of Chiropractic

03:40 Legislative Progress and Advocacy

04:33 Insurance Issues and Solutions

05:05 Exciting Developments and Conclusion

05:53 Call to Action: Get Involved

PCA Advocacy Team:

Jessica Treichler Email: [email protected]

Tim Faircloth Email: [email protected]

PCA Contact information:

PCA Website: https://pennchiro.org/

PCA Email: [email protected]

PCA Deep Dive: Opioid Addiction Doesn’t Start With a Pill, It Starts With Pain

In this episode of PCA Spinal Chat Deep Dive, the focus is on re-examining the opioid crisis from an upstream perspective. While most discussions center on the aftermath of addiction, this episode explores what happens before addiction begins, emphasizing the role of pain management in prevention. By comparing the latest guidelines on opioid use disorder with research advocating for conservative-first approaches like chiropractic care and physical therapy, the discussion highlights the importance of early pain management. Effective pain management can significantly reduce the need for surgeries and opioid prescriptions, potentially preventing addiction from ever starting. The conversation also delves into systemic issues, such as how authorization friction in healthcare policies often directs patients toward pharmacological solutions, rather than conservative care. This episode makes a compelling case for integrating upstream accountability with downstream compassion, stressing that regulating pathways to care is as crucial as regulating medications themselves.

00:00 Introduction to the Opioid Crisis

00:24 Understanding the Upstream Approach

01:09 Care Sequencing Explained

04:03 Current State of Opioid Use Disorder Treatment

06:50 The Role of Conservative Care

12:22 Barriers to Conservative Care

14:45 Conclusion and Call to Action

References

Messmer, J. M., et al. Management of Opioid Use Disorder: Clinical Guidelines Synopsis. JAMA, 2026. Available at: https://jamanetwork.com/journals/jama/fullarticle/250008

PCA Website: https://pennchiro.org/

PCA Email: [email protected]

Disclosure

The Pennsylvania Chiropractic Association did not generate this data. PCA Deep Dive reviews and discusses independent, peer-reviewed research to translate long-term outcomes and clinical implications for patients, clinicians, policymakers, and healthcare decision-makers.

From Fringe to First-Line: 50 Years of Evidence Now Defining Spinal Manipulation as Standard Care

In this episode of PCA Deep Dive, we explore a recent 2024 narrative review from the Journal of Clinical Medicine, focusing on spinal manipulation and chiropractic practice. Analyzing over 50 years of research and more than 6,000 studies, we examine the modern evidence on spinal manipulative therapy (SMT) and its role, safety, and clinical value in musculoskeletal care. We discuss the evolving academic focus from defensive research to high-quality methods, such as randomized controlled trials (RCTs) and systematic reviews, leading to robust clinical practice guidelines (CPGs) that strongly support SMT for conditions such as low back pain (LBP), neck pain, cervicogenic headaches, and tension-type headaches. We also address historical safety concerns and the current evidence indicating a low risk of adverse events. The episode underlines SMT’s position within integrated, evidence-based conservative care and highlights ongoing research pushing its application even further into general healthcare.

00:00 Introduction to PCA Deep Dive

00:58 Unpacking the Evidence: Spinal Manipulation and Chiropractic Practice

02:34 Historical Context and Research Evolution

05:23 Clinical Practice Guidelines and Recommendations

07:45 Expanding the Scope: Beyond Spine Care

09:15 Addressing Safety Concerns and Value Proposition

13:24 Conclusion and Future Directions

Primary Evidence Source

Clinical Practice Guidelines for Spinal Manipulative Therapy: A Narrative Review Journal of Clinical Medicine, 2024

This comprehensive narrative review analyzes more than 50 years of chiropractic and SMT research, mapping the profession’s progression from early regulatory and safety inquiries to modern guideline-supported clinical practice. The authors reviewed:

• 6,286 chiropractic-related publications spanning 1972–2024
• 33 clinical practice guidelines published between 2013 -2024
• 59 distinct guideline recommendations related to spinal manipulative therapy

Key findings include:

• Strong guideline support for SMT in low back pain and neck pain, particularly when delivered as part of multimodal, conservative care
• Demonstrated maturation of research quality, with a shift toward randomized controlled trials and systematic reviews
• No definitive causal link between SMT and serious vascular adverse events, with overall risk classified as rare
• Increasing alignment with value-based care goals, including reduced downstream imaging, medication use, and surgery

Direct link to the study: https://doi.org/10.3390/jcm13055668

PCA Website: https://pennchiro.org/

PCA Email: [email protected]

Disclosure

The Pennsylvania Chiropractic Association did not generate this data. PCA Deep Dive reviews and discusses independent, peer-reviewed research to translate long-term outcomes and clinical implications for patients, clinicians, policymakers, and healthcare decision-makers.

Capitol to Clinic: How PCA Moves Bills, Builds Relationships, and Protects Access

The Power of Advocacy: Strengthening the Future of Chiropractic Care in Pennsylvania

In this episode of Spinal Chat, host Mike Barb, Executive Director of the Pennsylvania Chiropractic Association (PCA), is joined by legislative liaisons Jessica Treichler and Tim Faircloth to discuss the vital advocacy efforts of the PCA. They delve into the significance of maintaining a consistent presence in the Capitol to protect and advance chiropractic care. Key initiatives being promoted include HB 1106 for scope modernization, copay reform, Conservative Care First, and sports chiropractic policies. The episode emphasizes the importance of grassroots involvement, engagement with legislators, and the power of chiropractors and their patients' voices. They also discuss the potential for collaboration between chiropractors and physical therapists and invite semi-retired or retired chiropractors to join the advocacy efforts. The conversation highlights the PCA's ongoing legislative goals and the collective effort required to secure the future of chiropractic in Pennsylvania.

00:00 Introduction to Spinal Chat Podcast

00:58 Meet the Legislative Liaison Team

02:02 Understanding Advocacy and Its Importance

02:57 Personal Stories and Experiences

04:12 The Role of Advocacy in Chiropractic

06:21 Engaging with Legislators and Community

07:32 Advocacy Day and Community Involvement

19:48 Legislative Goals and Future Plans

31:18 Call to Action and Final Thoughts

34:49 PCA's Legislative Agenda and Key Players

35:26 Meet Jessica Trier and Tim Faircloth

37:38 The Importance of Advocacy in Chiropractic

40:08 Advocacy Day and Grassroots Efforts

43:26 Engaging Legislators and Community Involvement

53:35 PCA's Legislative Goals and Scope of Practice

01:03:46 The Power of Advocacy and Community Support

01:05:05 Conclusion and Call to Action

Jessica Treichler Email: [email protected]

Tim Faircloth Email: [email protected]

PCA Website: https://pennchiro.org/

PCA Email: [email protected]

PCA Deep Dive: The Osteoarthritis Crisis: How the System Is Failing to Use Proven, Evidence-Based Care

In this episode of PCA Deep Dive, hosted by the Pennsylvania Chiropractic Association, the focus is on the escalating global health crisis of chronic joint pain driven by osteoarthritis (OA). The episode discusses the significant burden OA places on healthcare systems worldwide, highlighting the forecasted increase to nearly 1 billion affected individuals by 2050. Despite clear clinical guidelines advocating for conservative care and therapeutic exercise, many patients are receiving misaligned treatments. The discussion underscores the importance of movement and non-drug approaches in managing OA, explaining how a lack of movement contributes to cartilage degradation. The episode also explores the vital role of chiropractors as primary care providers for musculoskeletal issues, emphasizing their training and capabilities in delivering effective, cost-efficient care that aligns with evidence-based guidelines. Key statistics reveal systemic failures in current care pathways, underscoring the need for an integrated approach to close the treatment gap and improve patient outcomes. The episode concludes by urging the need to address environmental and behavioral risks to mitigate the looming OA crisis.

00:00 Introduction to PCA Deep Dive

00:18 The Global Health Crisis of Osteoarthritis

01:18 Understanding the Scale and Projections

03:59 The Role of Obesity and Sedentary Lifestyles

05:44 Therapeutic Exercise: The Best Medicine

09:00 The Treatment Gap and Systemic Failures

10:52 The Role of Chiropractors in Conservative Care

14:21 Conclusion and Call to Action

Primary Research & Evidence Sources

1. Global Burden of Disease Study – Osteoarthritis
   • Worldwide prevalence and years lived with disability projections
   • Osteoarthritis – GBD 2019 Analysis
2. Why Exercise Should Be First-Line Treatment for Joint Pain
   • Explains cartilage physiology, movement-driven joint nutrition, and guideline recommendations
   • Joint Pain or Osteoarthritis: Why Exercise Should Be Your First Line of Treatment
3. Collaborative Musculoskeletal Care and the Role of Chiropractors
   • Cost outcomes, scope, training, and conservative care integration
   • Collaborative Musculoskeletal Care: Chiropractors

PCA Website: https://pennchiro.org/

PCA Email: [email protected]

Disclosure

The Pennsylvania Chiropractic Association did not generate this data. PCA Deep Dive reviews and discusses independent, peer-reviewed research to translate long-term outcomes and clinical implications for patients, clinicians, policymakers, and healthcare decision-makers.

PCA Deep Dive: One Surgery Rarely Stays One: What 308,000 Patients Reveal

This episode of PCA Deep Dive, presented by the Pennsylvania Chiropractic Association, examines the critical decisions patients face when dealing with severe low back pain. The discussion centers on the impact of choosing initial care providers—comparing conservative management (such as chiropractic care) with surgical pathways. Using data from key studies, including long-term outcomes of lumbar discectomies, the episode highlights how initial decisions influence long-term surgical risks, reoperation rates, and the overall durability of surgical interventions. The insightful analysis emphasizes the importance of sequencing, risk management, and understanding the broader implications of early healthcare choices on lifelong spine health.

00:00 Introduction to PCA Deep Dive

00:09 The Immediate Crisis of Severe Low Back Pain

00:20 The Impact of Initial Care on Long-Term Outcomes

01:08 Comparing Initial Provider Choices

01:52 Statistical Analysis of Surgical Risks

02:19 The Conservative Pathway vs. Surgical Pathway

06:04 Understanding Surgical Durability

08:31 Factors Influencing Surgical Outcomes

10:58 Implications for Patients and Healthcare Systems

14:28 Conclusion and Key Takeaways

Study Attribution & Source

This episode references findings from the following peer-reviewed study published in Spine:

Etigunta, S.K., Liu, A.M., Gausper, A., Chan, V., Scheer, J., Perry, T., Skaggs, D.L., Walker, C., & Tuchman, A. Long-Term Reoperation Rates After Single-Level Lumbar Discectomy: A Nationwide Cohort Study. Spine, Volume 50, Issue 15, August 1, 2025.

The study is a retrospective cohort analysis of 308,979 patients followed for at least 5 years, evaluating long-term reoperation and fusion rates following single-level lumbar discectomy.

Journal Link (DOI): https://doi.org/10.1097/BRS.0000000000005328

PCA Website: https://pennchiro.org/

PCA Email: [email protected]

Disclosure

The Pennsylvania Chiropractic Association did not generate this data. PCA Deep Dive reviews and discusses independent, peer-reviewed research to translate long-term outcomes and clinical implications for patients, clinicians, policymakers, and healthcare decision-makers.