October 2004

Study proves chiropractic coverage lowers healthcare costs

A four-year retrospective claims data analysis comparing more than 700,000 health plan members who had chiropractic coverage and 1 million members of the same plan without a chiropractic benefit showed that chiropractic coverage kept down healthcare costs.

The study was reported in the Oct. 11, 2004, issue of the Archives of Internal Medicine, published by the American Medical Association. A report of the study was published on the popular medical-information Web site, WebMD (www.WebMD.com).

According to the study, the total healthcare costs of those who had the chiropractic benefit were $1,463 vs. $1,671 for individuals who did not have the benefit.

The study concluded that chiropractic care:

• Cut the cost of treating back pain by 28 percent;

• Reduced hospitalizations among back pain patients by 41 percent;

• Decreased back surgeries by 32 percent;

• Reduced the cost of medical imaging, such as x-rays and MRIs, by 37 percent.

The study was sponsored by American Specialty Health (ASH) of San Diego and conducted by independent health services research organization Health Benchmarks Inc. It is reportedly the largest study ever done that compared back-treatment costs for individuals with and without chiropractic health plan coverage.

“Prior to this no study had ever linked chiropractic benefits to lower utilization levels in a real-world employee setting,” said co-investigator Douglas Metz, DC, chief health services officer for American Specialty Health. “Our study shows that systematic access to managed chiropractic care may prove to be not only clinically beneficial but can reduce key cost factors that drive up employer health costs in traditional care settings.

The study authors (Antonio P. Legorreta, MD, MPH; R. Douglas Metz, DC; Craig F. Nelson, DC, MS; Saurabh Ray, PhD; Helen Oster Chernicoff, MD, MSHS; and Nicholas A. DiNubile, MD) concluded:

“Access to managed chiropractic care may reduce overall healthcare expenditures through several effects, including:

“1. Positive risk selection;

“2. Substitution of chiropractic for traditional medical care, particularly for spine conditions;

“3. More conservative, less invasive treatment profiles; and

“4. Lower health service costs associated with managed chiropractic care.

“Systematic access to managed chiropractic care not only may prove to be clinically beneficial but also may reduce overall healthcare costs.”

The Archives of Internal Medicine published an editorial on the study, in addition to the study itself. The editorial, “Cracking the problem of back pain,” said in part:

”Chiropractic is certainly one of the most popular therapeutic modalities encompassed by complementary and alternative medicine … The [four-year retrospective study] raises the intriguing possibility that chiropractic may in fact be the more economic approach to the management of the complex, ill-defined, recurrent and often refractory symptom of back pain.”

Sources: Archives of Internal Medicine, http://archinte.ama-assn.org/, WebMD, http://my.webmd.com/content/article/95/103236.htm; American Specialty Health Plans Inc., http://www.ASHCompanies.com; American Chiropractic Association, http://www.acatoday.com.

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