Chiropractic is Mainstream

Chiropractic Works and Saves Money

In the U.S., the total annual cost for health care and lost productivity related to low-back pain is estimated to be nearly $100 billion! Research indicates that low-back pain is the most expensive source of workers' compensation costs in North America.

Numerous studies show chiropractic is an effective and efficient means of natural healing. Below are just some of these studies and their findings.

The Manga Report is the most comprehensive analysis of low-back pain to date. Commissioned by the Ontario Ministry of Health, the report shows chiropractic treatment is cost-effective, safe, has a high rate of patient satisfaction, and is more effective than medical treatment for low-back pain.

The report recommends management of low-back pain be moved from medical doctors to chiropractors and found that injured workers with low-back pain returned to work much sooner when treated by chiropractors than by medical doctors. The report also notes evidence that patients are much more satisfied with chiropractic management of low-back pain than with medical management.

The Manga Report concluded: "There would be highly significant cost savings if more management of low-back pain was transferred from physicians to chiropractors. Users of chiropractic care have significantly lower health care costs, especially inpatient costs, than those who use medical care only."

A study published in the October 11, 2004 edition of the Archives of Internal Medicine compared 700,000 health plan members with a chiropractic benefit with 1 million members of the same plan who did not have the chiropractic benefit. The study found that members with chiropractic coverage had lower annual total health care expenditures per member per year ($1,463 vs. $1,671). Having chiropractic coverage was associated with a 1.6% decrease in total annual health care costs at the health plan level. Also, patients with chiropractic coverage had lower average back pain episode related costs ($289 vs. $399).

In this study, a chiropractic network in which DCs performed all patient examinations, treatments, and procedures at their own discretion was constructed. Recommended follow-up visits, choice of appropriate treatment, and ancillary therapies utilized did not require approval from an MD. The original study, which focused on the years 1999-2002, found decreases of: 43 percent in- hospital admissions per 1,000; 58.4 percent in hospital days per 1,000; 43.2 percent in outpatient surgeries and procedures per 1,000; and, 51.8 percent in pharmaceutical costs. It noted that: "The AMI experience seems to indicate that a nonpharmaceutical/nonsurgical orientation can reduce overall health care costs significantly and yet deliver high quality care."

This study was updated in 2007, covering the years 2003-2005. The results of the original study were confirmed, with demonstrated decreases of 60.2 percent in in-hospital admissions, 59 percent in hospital days, 62 percent in outpatient surgeries and procedures, and 85 percent in pharmaceutical costs.

This study, conducted by Oakland University Economics Professor Dr. Miron Stano, found that, when costs of advanced imaging and referrals to physical therapists and other providers were added, chiropractic care costs for chronic patients were 16 percent lower than medical care costs. If the study would have included hospitalization or surgical costs, two very expensive medical treatments for low-back pain, or over-the-counter medications, the savings from chiropractic would have been even greater. Additionally, chiropractic patients showed an advantage over medical patients in pain, disability, and satisfaction outcomes.

This study demonstrates that chiropractic care leads to lower costs by reducing the rates of surgery, advanced imaging, inpatient care, and plain-film radiographs in patients with low-back and neck pain. The study examined the claims data from a managed care health plan over a four-year period. The use rates of the high-cost procedures mentioned above were compared between employer groups with and without a chiropractic benefit. For patients with both low back and neck pain, the use rate of all four of these categories was lower in the group with chiropractic coverage. See the table below.

The study concludes: "Among employer groups with chiropractic coverage compared with those without such coverage, there is a significant reduction in the use of high-cost and invasive procedures for the treatment of back pain."

This study looked at more than 43,000 workers comp. claims over a 19-year period (1975-1994) and found dramatic differences in the average treatment costs between chiropractic patients, medical patients, and patients treated by both. The analysis revealed that the average total cost of an injured worker's claim managed by a medical doctor was $21,774 more than claims managed by a DC. For chiropractic patients, however, average treatment costs were only $663, roughly 18 percent of the cost of medical care, and 13 percent of the cost of combined care.

Additionally, injured workers treated by chiropractors experienced lost work days for an average of 33 days, 143 days less than workers seeing an MD, and more than 200 days less than workers treated by MDs and DCs, and hospital inpatient and outpatient care costs for medical patients were $1,995 and $2,161 more per worker, respectively, than for chiropractic patients.

The study concluded: "It seems likely that substantial savings to the workers compensation system would be possible if chiropractic services were increased in North Carolina."

The British Medical Research Council conducted a 10-year study that showed chiropractic care was significantly more effective than medical treatment for patients with chronic and severe pain.

This study compared the effectiveness of manual therapy, physical therapy, and continued care by a general practitioner in patients with nonspecific neck pain. The success rate at seven weeks was twice as high for the manual therapy group (68.3 percent) as for the continued care group. Manual therapy scored better than physical therapy on all outcome measures. Additionally, patients receiving manual therapy had fewer absences from work than patients receiving physical therapy or continued care, and manual therapy resulted in statistically significant less analgesic use than continued care.

This study found loss of work time under chiropractic care is less than one-third of the time lost under medical care. The study also found that the average medical cost per patient was 260 percent higher than the average chiropractic cost.

Another recent study published on the Chiropractic Resource Organization website reported the cost of treating episodes of low-back pain was 28 percent lower in patients whose health plan provided chiropractic coverage compared to health plans without coverage. And, total health care costs were 12 percent less for patients in plans that reimbursed for chiropractic services.

Oakland University found "patients who received chiropractic care incurred significantly lower health care costs than patients treated solely by medical or osteopathic physicians." Total insurance payments were 30 percent higher for patients who elected medical care only.

The Texas Chiropractic Workers' Compensation Report found the average claim for a worker with a low-back injury was $15,884. If a chiropractor provided at least 90 percent of the care, however, the average cost declined by more than 50 percent, to $7,632.

This study found chiropractic care was substantially more cost-effective than conventional care. The authors also concluded that properly managed chiropractic care can yield outcomes, in terms of surgical requirements and patient satisfaction, that are equal to those of non-chiropractic care, at a substantially lower cost per patient.

The Utah Study compared the cost of chiropractic care to the cost of medical care for conditions with identical diagnostic codes and found that cost was almost 10 times higher for medical than for chiropractic claims. Also, the number of work days lost was nearly ten times higher for those who received medical care.

The Florida Study showed patients receiving chiropractic care rather than medical care had lower treatment costs by more than 50 percent.