Cost Effectiveness

Haas, M, Sharma R, Stano M. Cost Effectiveness of Medical and Chiropractic Care for Acute and Chronic Low Back Pain. Journal of Manipulative and Physio Ther. 2005, 28:555-563. Significant direct savings were made for those patients who used chiropractic care versus medical care. Indirect costs were not evaluated and are estimated to be even more favorable for chiropractic care and management.

Legorreta AP. Metz RK, Nelson CF et al.  (2004) Comparative Analysis of Individuals with and Without Chiropractic Coverage, Patient Characteristics, Utilization and Costs, Arch Intern Med 163: 1985-1992, October 11, 2004.  Four year study from 1.7 million members of a managed care network in California, providing medical services only for 1 million members but the same medical services plus chiropractic services for 700,000 members reported the following.  Among plan members who were treated for neuromusculoskeletal conditions, total health care costs were 13% lower for those with chiropractic coverage.  The cost of treating episodes of low back pain was 28% lower in the group with chiropractic coverage.  Nelson concluded “inclusion of chiropractic benefit in a managed care plan results in a reduction in the overall utilization of health care resources, and thereby cost savings”.  In particular this managed care plan would have saved $47.5 million over four years if all of its 1.7 million members had chiropractic coverage. 

2/12/2001: For approximately 2 years Blue Cross Blue Shield of Illinois, that states largest managed care plan, has given their more than 700,000 members an option of choosing a chiropractor as their primary care physician.  The goal is to evaluate a true prevention-based health care system as opposed to an after-the-fact disease care system.  The results of this program as supplied by BC/BS of Illinois, compared to similar managed care plans employing medical doctors as PCP’s is the following.

1)      Hospitalizations reduced by approximately 60%

2)      Outpatient surgery reduced by approximately 85%

3)      Usage of pharmaceuticals reduced by approximately 56%

4)      Reduction of Cesarean sections by over 22 percent

5)      Higher patient satisfaction rates

10/31/2000: President Clinton signs into law direct access, without referral, to chiropractic doctors for active military personnel which was directed to be implemented by October 1, 2001.

3/20/2000: The Department of Defense recently completed a congressionally mandated, multi-year pilot program to determine the feasibility and advisability of including chiropractic care in the DOD health care system.  Results were:

·        Military personnel who used chiropractic care for the treatment of common neuromusculoskeletal conditions experienced superior outcomes compared to patients who received traditional care and physical therapy. 

·        A higher proportion of chiropractic patients reported that they felt better, had less pain, and had fewer restrictions/physical limitations than patients receiving traditional care. 

·        More combat readiness

·        199,000 less lost work days

·        An assessment was made that implementing chiropractic care within the military would save the Department of Defense over 25 million dollars per year. 

Dr. Scott Donkin’s BACKSAFE and SITTING SAFE employee training programs for the prevention of neck and back injuries are now in wide use with major corporations because of impressive results such as:

·        United Airlines, after training 20,000 flight attendants in 10 countries with the Backsafe program led by chiropractors as trainer, saw a 63% decrease in neck and back injuries.

·        Boeing reduced back injuries by 41%

·        Citicorp in Beverly Hills experienced a 50% reduction in back injuries after employees received this training.

·        Results similar to those of Citicorp were realized by Chevron and Merrill Lynch.

Dean, D.H., Schmidt, R.M., A Comparison of the Costs of Chiropractors versus Alternative Medical Practitioners, University of Richmond, Richmond, Virginia, 13 January 1992.

An economic analysis was performed and the results were that chiropractic

treatment is a lower cost option for many common back-related problems.  The

study also stated that if chiropractic care were covered by insurance as well as other

specialties, it may result in chiropractic treatment becoming the first option for care.

This in turn could very well decrease the overall treatment cost for these conditions.

Schifrin, L.G., Mandated Health Insurance Coverage for Chiropractic Treatment:  an Economic Assessment, with Implication for the Commonwealth of Virginia.  The College of William and Mary, Williamsburg, Virginia, and Medical College f Virginia, Richmond, Virginia, January 1992.

This study of mandated health insurance coverage and the economic impact of

chiropractic coverage showed that by every test chiropractic care provided

therapeutic benefits at comparably more economical costs, with a minute effect on

costs of health insurance.

The New Zealand Report (1979) authored by the government of New Zealand, stated that on the basis of its education, research, safety, practice and principles, the modern chiropractic profession is a soundly based and valuable branch of the healing arts.  Its services should be recognized and funded in government health care plans.

Manga P, Angus D, et al.  The Effectiveness and Cost Effectiveness of Chiropractic Management of Low Back Pain.  The Ontario Ministry of Health, Ottawa, Ontario, Canada, August 1993.  This study showed that the preventive impact of regular spinal adjustment would save millions of health care costs, possibly 100 million dollars per year.

RECENT STUDIES HAVE SHOWN CHIROPRACTIC CARE AS A LOWER COST ALTERNATIVE WITH EQUAL OR SUPERIOR RESULTS

Ebrall, P.S., “Mechanical Low-Back Pain”.  A Comparison of Medical and Chiropractic Management Within the Victorian WorkCare Scheme,” Chiropractic Journal of Australia, June 1992, Volume 22, Number 2, Pages 47-53.

Jarvis, K.B., Phillips, R.B. et al.  “Cost per Case Comparison of Back Injury Claims of Chiropractic versus Medical Management for Conditions with Identical Diagnostic Codes, Journal of Occupational Medicine, August 1991, Volume 33, Number 8, Pages 847-852.

Wolk, S.  Chiropractic versus Medical Care: A Cost Analysis of Disability and Treatment for Back-Related Workers’ Compensation Cases.  Foundation of Chiropractic Education and Research, Arlington, Virginia, September 1988.

A Florida Study.  “An Analysis of Florida Worker’s Compensation Medical Claims for Back-Related Injuries,” ACA Journal of Chiropractic, 1988.

Mosley, Cohen, D.C., Arnold, M.D.  American Journal of Managed Care.  1996; 2: 280-282.

This was a retrospective study of patients at an independent physician model HMO in Louisiana evaluating cost of care for back or neck pain for patients who sought chiropractic care (121 people) or other treatment (1,838 people).  RESULTS:  patient satisfaction and symptom relief was equal with chiropractic costs being substantially lower.  Chiropractic cost vs. Medical costs ($539 vs. $774).