Does Chiropractic Make Cents?
Dear Patients & Friends:
For years scientists did not know whether chiropractic manipulation was effective for back pain. In 1994, when the US Agency for Healthcare Care Policy and Research (AHCPR) concluded that spinal manipulation was both “safe and effective” for acute back pain, scientists began to look at whether chiropractic was also cost-effective. In other words, is it only marginally effective but expensive? Or alternatively, do treatments provide meaningful clinical relief at equal or reduced cost when compared with other medical treatments for the same type problem(s)?
Scientists reporting in a March 2012 issue of Spine reported that about 6% of adults in the United States (13.6 million) made a visit for neck or back pain in 2008. During the 10-year period prior to that, annual expenses on medical care for these patients increased by 95%, (from $487 to $950). Most of the increase in costs was due to expenses for medical specialists as opposed to primary care doctors and chiropractors. For example, over the study period expenses on chiropractic care were stable, while physical therapy was the most costly service.
Other studies have reached similar conclusions. For example, we previously reported the savings from a pool of 669,320 Blue Cross Blue Shield of Tennessee subscribers, including 85,402 diagnosed with disc or back pain disorders by a doctor of osteopathy, chiropractic, medicine, or an emergency room physician between 2004 and 2006.
Writing in the Journal of Manipulative and Physiological Therapeutics, Richard L. Liliedahl, M.D. and co-workers, reported that costs paid by BCBS for chiropractic services were almost 40% less than costs paid by the insurer for medical care, and even after risk adjusting (e.g., comparing only medical versus chiropractic patients with disc problems), patients attended by a doctor of chiropractic experienced almost 20% less expense when compared with patients seen by a medical doctor.
While neither of these studies addressed the “effectiveness” of chiropractic compared with physical therapy or surgery, dozens of prior studies we have previously discussed have shown that chiropractic care is at least as effective, if not superior to these other treatments. Indeed, even the Federal AHCPR guidelines concluded that only 1 in 100 backs benefits from surgery. So does chiropractic make cents? If future studies verify these cost savings, the answer may well be, “yes, trillions of them!”
Robert A. Leach, DC, MS, CHES, FICC(h)
1. To read the new research in Spine Journal indicating medical care costs (mainly associated with specialist care) may have doubled in America in the past decade, while chiropractic care costs remained stable: http://www.ncbi.nlm.nih.gov/pubmed/22433497
2. For the November/December 2010 research demonstrating lower costs for back pain treatment in BCBS of Tennessee members who go to chiropractors: http://www.jmptonline.org/article/S0161-4754%2810%2900216-2/abstract
3. For a review of studies that document increased patient satisfaction with chiropractic care: http://www.ncbi.nlm.nih.gov/pubmed/16523145
4. To view the archived US Agency for Healthcare Policy and Research guidelines that discuss “safety and effectiveness” of spinal manipulation, and reveal that only only 1 in 100 backs benefits from surgery: http://www.ncbi.nlm.nih.gov/books/NBK52120/#A34348