Over the past few years continuously mounting evidence has shown chiropractic care to be more efficacious, more cost effective, and according to patients, the preferred treatment above any other form of care for spine-related disorders. These are just a few of the studies demonstrating our effectiveness:
A recent issue of the American Medical News included an article discussing the changes managed care has brought to health care.4 The article reviewed a study conducted by Peat Marwick comparing the impact of care provided under "high managed care" vs. "low managed care." The results were as follows:
| High Managed Care | Low Managed Care | |
| Hospital Costs | 11.5% below national average | 3.6% above |
| Patient Stays | 16.9% shorter than expected | 17.5% longer |
| Mortality Rates | 8% lower than expected | 2% lower |
The most recent issue of The Back Letter included an article reporting an interesting study comparing the cost per episode for acute back care patients. Chiropractic care was compared to medical care and HMO medical care. Here are the results:
HMO Primary Care Physicians -- $448 per caseThis study has not yet been published, so there is no way to assess the methodology, but the article suggests that the algorithms used by the HMOs may have made the difference. The Back Letter article also states that "(p)atient satisfaction was significantly higher among the patients seeing chiropractors when compared with any MD stratum."Rural Primary Care Physicians -- $515 per case
Rural Chiropractors -- $657 per case
Orthopedic Surgeons -- $771 per case
Urban Chiropractors -- $814 per case
The important point is to recognize that managed care is a new ball game with its own rules and ways of measuring efficacy. Thousands of DCs are currently involved in managed care, like it or not, and all providers are being measured against their managed care counterparts.
For years we have aspired to a "level-playing field," a position where chiropractic could fairly compete head-to-head with medicine. Research was beginning to look like chiropractic's entree onto that playing field.
But business segments have built a larger arena that is attracting the nation's attention. In the United States, politicians are looking to managed care to solve the problems of Medicare and Medicaid. It has become the "big show."
So while some back studies reveal that patients prefer chiropractic over medical care, and that the effectiveness of the chiropractic care was greater than its medical counterpart, the question is: Can chiropractic care continue to prove its cost effectiveness in the managed care arena?
When the MDs weren't as focused about cost control, they were no competition. Now they are fighting for their lives from the inside. It will require all of our resources and savvy to not only demonstrate chiropractic's cost effectiveness in managed care, but to do so while establishing chiropractic's proper place within HMOs, PPOs, and their health care algorithms.
For those DCs who wish to be involved in managed care (it's not for everyone), the challenge is before us.
References
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
