Chiropractic Usage & Costs: Cost Comparison for Chiropractic vs Medical Doctor

This week from Dr. Cerami and Utah Sports and Wellness

From: Journal of Manipulative and Physiological Therapeutics, November/December 2010

Quick Summary:

With about 70% to 85% of Americans experiencing back pain at some point in their lives, chances are there will come a time when you will be looking for treatment options. This study was done to determine if there are differences in the cost of low back pain treatment courses between medical doctors vs doctors of chiropractic. The authors found “statistically significant lower costs in episodes of care initiated with a DC as compared to an MD.” While also showing that 61% of chiropractic patients reported their care as being “very helpful” with only 27% of medical patients reporting the same.

Abstract:

The primary aim of this study was to determine if there are differences in the cost of low back pain care when a patient is able to choose a course of treatment with a medical doctor (MD) versus a doctor of chiropractic (DC), given that his/her insurance provides equal access to both provider types. A retrospective claims analysis was performed on Blue Cross Blue Shield of Tennessee’s intermediate and large group fully insured population between October 1, 2004 and September 30, 2006. The insured study population had open access to MDs and DCs through self-referral without any limit to the number of visits or differences in co-pays to these 2 provider types. Our analysis was based on episodes of care for low back pain. An episode was defined as all reimbursed care delivered between the first and the last encounter with a health care provider for low back pain. A 60 day window without an encounter was treated as a new episode. We compared paid claims and risk adjusted costs between episodes of care initiated with an MD with those initiated with a DC. Paid costs for episodes of care initiated with a DC were almost 40% less than episodes initiated with an MD. Even after risk adjusting each patient’s costs, we found that episodes of care initiated with a DC were 20% less expensive than episodes initiated with an MD. Beneficiaries in our sampling frame had lower overall episode costs for treatment of low back pain if they initiated care with a DC, when compared to those who initiated care with an MD.

These authors also note:

• “About a quarter of the adult population reports LBP in any 3-month period.”
• Back problems are one of the top 10 most costly conditions treated in the US. 61% of chiropractic patients report their care as being very helpful
• Only 27% medical care patients report their care as being very helpful
• “Care initiated with a DC is still significantly, and sizably, less for patients seeking care for the 6 International Classification of Diseases, Ninth Edition, low back-related disorders investigated in this study.”
• These authors calculated that in the assessed local insurance, using chiropractors v. medical doctors could save “more than $2.3 million per year.”
• “Our results support a growing body of evidence that chiropractic treatment of low back pain is less expensive than traditional medical care.”
• “We found that episode cost of care for LBP initiated with a DC is less expensive than care initiated through an MD.”
• “Paid costs for episodes of care initiated with a DC were almost 40% less than episodes initiated with an MD.”
• “Our results suggest that insurance companies that restrict access to chiropractic care for LBP may, inadvertently, be paying more for care than they would if they removed these restrictions.”
• “Paid costs for episodes of care initiated with a DC were almost 40% less than episodes initiated with an MD.”
• “Beneficiaries in our sampling frame had lower overall episode costs for treatment of low back pain if they initiated care with a DC, when compared to those who initiated care with an MD.”