The Cost Effectiveness of Chiropractic Care

Low back pain is a significant public health problem

Up to 85 percent of Americans have back pain at some point in their lives and low back pain is the fifth most common reason for all physician visits in the United States!

In addition to its negative effects on employee productivity, back pain treatment accounts for about $50 billion annually in health care costs—making it one of the top 10 most costly conditions treated in the United States.

Blue Cross Blue Shield of Tennessee (2010)
Low back pain initiated with a doctor of chiropractic (DC) saves 40 percent on health care costs when compared with care initiated through a medical doctor (MD), according to a study that analyzed data from 85,000 Blue Cross Blue Shield (BCBS) beneficiaries in Tennessee over a two-year span. 

According to the study, “Chiropractic care appeared relatively cost-effective for the treatment of chronic low-back pain. Chiropractic and medical care performed comparably for acute patients. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulative efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapeusis.”

The study “Cost of Care for Common Back Pain Conditions Initiated With Chiropractic Doctor vs. Medical Doctor/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer,” is available online and was published in the December 2010 issue of the Journal of Manipulative and Physiological Therapeutics. 

The study population had open access to MDs and DCs through self-referral, and there were no limits applied to the number of MD/DC visits allowed and no differences in co-pays. Researchers estimated that allowing DC-initiated episodes of care would have led to an annual cost savings of $2.3 million for BCBS of Tennessee. They also concluded that insurance companies that restrict access to chiropractic care for low back pain treatment may inadvertently pay more for care than they would if they removed such restrictions!

“As doctors of chiropractic, we know firsthand that our care often helps patients avoid or reduce more costly interventions such as drugs and surgery. This study supports what we see in our practices every day,” said ACA President Rick McMichael, DC. “It also demonstrates the value of chiropractic care at a critical time, when our nation is attempting to reform its health care system and contain runaway costs.”

Center for Health Value Innovation Report (2010)
The Center for Health Value Innovation (www.vbhealth.org) is a membership organization of employers and insurance plan sponsors that “shares actionable health data, strategies and tools for better business performance.”

This organization’s core mission is to align incentives for individual responsibility and corporate accountability. CHVI’s 2010 report, “Outcomes-Based Contracting™: The Value-Based Approach for Optimal Health with Chiropractic Services,” addresses the role of chiropractic services as part of the continuum of care in value-based benefit design.


After analyzing available data on clinical effectiveness and cost-effectiveness, CHVI concluded that “the addition of chiropractic coverage for the treatment of low back and neck pain at prices typically payable in US employer-sponsored health plans will likely increase value-for-dollar.”

• For low back pain, care initiated with a chiropractor (DC) is less costly than care initiated through a Medical Doctor (MD). Paid costs for episodes of care initiated with a DC are almost 40% less then episodes initiated with an MD.
• Even after risk adjusting each patient's costs episodes of care initiated with a DC are 20% less expensive than episodes initiated with an MD.

Go see your chiropractor! 
If you've never visited a chiropractor, there is good chance that you have been paying more than necessary for your medical care.  This study illustrates how DCs are more efficient with their care for low back pain and luckily, DCs do much more than that!  Make an appointment for family care, pregnancy, sports injuries, or any reason you'd like to try a more satisfying and cost effective treatment for. 

Sources:
– Liliedahl et al (2010), Journal of Manipulative and Physiological Therapeutics
– Haas et al (2005), Journal of Manipulative and Physiological Therapeutics