Billing / Fees / Insurance

Study Suggests Availability of Chiropractic Care Improves Value of Health Benefit Plans

A report commissioned by the Foundation for Chiropractic Progress (FCP) and prepared by a global leader for trusted human resources and related financial advice, products and services has found that the addition of chiropractic care for the treatment of low back and neck pain will likely increase value-for-dollar in U.S. employer-sponsored health benefit plans. Authored by Niteesh Choudhry, MD, PhD, and Arnold Milstein, MD, the report can be fully downloaded free of charge: Full Report.

The report was commissioned by the FCP to summarize the existing economic studies of chiropractic care published in peer-reviewed scientific literature, and to use the most robust of these studies to estimate the cost-effectiveness of providing chiropractic insurance coverage in the U.S.

Gerard Clum, DC, spokesperson for the foundation and president of Life Chiropractic College West, says, "While some studies reflect cost efficiencies and others clinical efficiencies, these findings strongly support both for chiropractic care of neck pain and low back pain." Dr. Clum points out that annual national spending on spine-related problems is estimated to be $85 billion in the U.S, an inflation-adjusted increase of 65 percent compared with 1997. (JAMA, 2008;299:656-64, www.ncbi.nlm.nih.gov/pubmed/18270354)

According to Kent S. Greenawalt, chairman and director of the FCP, "The Foundation for Chiropractic Progress is proud to present one of the most significant reports regarding the cost effectiveness and clinical efficacy of chiropractic care in the history of the profession. Prepared by two distinguished, globally renowned medical researchers, we believe this report can change the landscape of how chiropractic is viewed by the world. Help us to get this message out to the consumer, business and global health care communities by becoming a monthly contributor today: www.foundation4cp.com/involved."

The foundation is hand-delivering this report to members of Congress, state and national associations, and other key health care influencers and decision-makers throughout the country.

Executive Summary:

Low back and neck pain are extremely common conditions that consume large amounts of health care resources. Chiropractic care, including spinal manipulation and mobilization, are used by almost half of U.S. patients with persistent back pain seeking out this modality of treatment.

The peer-reviewed scientific literature evaluating the effectiveness of U.S. chiropractic treatment for patients with back and neck pain suggests that these treatments are at least as effective as other widely used treatments. However, U.S. cost-effectiveness studies have methodological limitations.

High-quality randomized cost-effectiveness studies have to date only been performed in the European Union (EU). To model the EU study findings for U.S. populations, researchers applied U.S. insurer-payable unit price data from a large database of employer-sponsored health plans. The findings rest on the assumption that the relative difference in the cost-effectiveness of low back and neck pain treatment with and without chiropractic services are similar in the U.S. and the EU.

The results of the researchers' analysis are as follows:

  • Effectiveness: Chiropractic care is more effective than other modalities for treating low back and neck pain.
  • Total cost of care per year: For low back pain, chiropractic physician care increases total annual per patient spending by $75 compared to medical physician care.*
  • For neck pain, chiropractic physician care reduces total annual per patient spending by $302 compared to medical physician care.
  • Cost-effectiveness: When considering effectiveness and cost together, chiropractic physician care for low back and neck pain is highly cost-effective, represents a good value in comparison to medical physician care and to widely accepted cost-effectiveness thresholds.

These findings, in combination with existing U.S. studies published in peer-reviewed scientific journals, suggest that chiropractic care for the treatment of low back and neck pain is likely to achieve equal or better health outcomes at a cost that compares very favorable to most therapies that are routinely covered in U.S. health benefits plans. As a result, the addition of chiropractic coverage for the treatment of low back and neck pain at prices typically payable in U.S. employer-sponsored health benefit plans will likely increase value-for-dollar by improving clinical outcomes and either reducing total spending (neck pain) or increasing total spending (low back pain) by a smaller percentage than clinical outcomes improve.

* As Greenawalt notes, "[T]he report did not include analysis of prescription drug costs, a factor that is likely to have increased overall cost of medical physician services."

Source: Foundation for Chiropractic Progress

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