September 2006

Study gives hard data on chiropractic use

A study released in July by researchers in the state of Washington shows that 10.9 percent of the state’s insured residents use chiropractic.

The research, “Insurance Coverage and Subsequent Utilization of Complementary and Alternative Medicine Providers,” studied the actual use of complementary and alternative medicine by more than 600,000 enrollees of healthcare plans in the state of Washington.

Washington has mandated chiropractic coverage since 1983. In 1996, the state implemented a law mandating all commercial health insurance companies to cover the services provided by every category of licensed provider.

According to the researchers, “The state of Washington provides an important laboratory to assess the magnitude of economic risk when a third-party payer covers CAM providers.”

Data for calendar year 2002 were included for all individuals 18 to 64 years of age who were continuously enrolled for 12 months in a single private health insurance plan. Self-insured employer plans were excluded.

CAM claims accounted for 13.7 percent of all claims made, including

Patients enrolled in preferred provider organizations (PPO) and point-of-service products (POS) were more likely to use CAM than those with HMO coverage. Women used came more than men, and persons 31-50 years old were the most frequent users.

Interestingly, chiropractic was more frequent in less populous counties. CAM provider visits usually focused on musculoskeletal complaints, except for naturopathic physicians, who treated a broader array of problems.

The median per-visit expenditure for CAM care was $39, and for conventional outpatient care, $74. The total expenditures per enrollee were $2,589, of which $75 (2.9 percent) was spent on CAM.

The authors of the Washington study, which was published in the American Journal of Managed Care, concluded that the number of people using CAM insurance benefits was substantial, yet the effect on insurance expenditures was modest.

In 2004, the National Center for Complementary and Alternative Medicine (NCCAM) published a comprehensive survey of more than 31,000 Americans. The survey noted that about 8 percent of the population had used chiropractic during the previous 12 months, and approximately 20 percent had visited a chiropractor at least once.

Sources: The American Journal of Managed Care, www.ajmc.com; National Center for Complementary and Alternative Medicine, www.nccam.nih.gov.