Archive for the ‘Chiropractic cost effective-Blue Cross Blue Shield claims analysis-JMPT 2010’ Category

Chiropractic cost effective-Blue Cross Blue Shield claims analysis-JMPT 2010

February 28, 2011

Journal of Manipulative and Physiological Therapeutics (JMPT) 2010;33(9):640-43.

Cost of Care for Common Back Pain Conditions initiated with DC versus MD/DO as First Physician: Experience of one of Tennessee-based General Health Insurer.

Richard L. Liliedahl, MD, Michael D. Finch, PhD, David V. Axene, FSA, FCA, MAAA, Christine M. Goertz, DC, PhD

Key Points:

This retrospective claims analysis of some 85,402 patients insured by Blue Cross Blue Shield in Tennessee who sought help for Low Back Pain.

Chiropractic care:  A $2.3 million per year savings is substantial and, clearly, cost-effective.

There treatment was initiated by either a DC or MD demonstrates that treatment for an episode of Low Back Pain with a chiropractor results in lower costs for Low Back Pain  care than episodes initiated by an medical doctor even after controlling for severity of the patients presenting complaints.

This is a very large population of patients insured by one of the major insurers in the USA.

The discussion section explains that by restricting access to chiropractic care, insurers may be paying more for management of Low Back Pain episodes than if they allowed unrestricted access to chiropractic care.

This is a very significant finding which may cause health insurance companies to reappraise their policies concerning restricted access to chiropractic care.

A retrospective claims analysis study (October 2004 thru Sept 2006) on Blue Cross Blue Shield of Tennessee’s intermediate & large group fully insured population to determine if there are differences in the cost of Low Back Pain care, including visits & medications (narcotic, analgesic, nonsteroidal, and muscle relaxants), when a Patient can choose Treatment with  a MD or a DC.

Coverage included unrestricted access to primary & specialty providers of their choice & unlimited services, except for a 20-visit/yr year limit on physical therapy.

There were no differences in this population for co-pays or deductibles based on provider type.

Patients had open access to MDs & DCs thru self-referral without any limit to the number of visits or differences in co-pays to these 2 provider types.

Analysis is based on episodes of care for Low Back Pain: reimbursed care delivered between the 1st & last visit with a health care provider for Low Back Pain. A 60 day window without treatment is considered a new episode.

Results:

Paid costs for episodes of Low Back Pain care initiated with a chiropractor were almost 40% less than episodes initiated with an MD.

Even after risk adjusting each Patients costs (determining the severity of clinical presenting symptoms), episodes of care initiated with a DC were 20% lower than those initiated with an MD.

Conclusions: Paid costs for episodes of care initiated with a DC were almost 40% less than episodes initiated with an MD. Even after risk adjusting each patient’s costs, episodes of care initiated w a DC are 20% less expensive than episodes initiated with an MD. Results suggest that insurance companies that restrict access to chiropractic care for Low Back Pain may, inadvertently, be paying more for care than they would if they removed these restrictions. Savings to the payer for allowing unrestricted access to chiropractic care would result in a saving of $2.3 million per year.

Another good article on Chiropractic being Cost effective: Chiropractic vs. Medicine for Acute Low Back Pain- Spine Journal 2010

Another good article on:  Chiropractic being Cost effective

If you are suffering from: Sports Injuries, Sprains, Strains, Car accident,  Herniated Disc, Disc Bulge, Degenerative Disc Disease, Neck pain, Headaches, Low back pain, of just want to feel better and have better life performance– please call our office in Irvine, California- at 949.857.1888or visit our website at ADJUST2IT to learn more about Functional Fitness Chiropractic, Sports massage, Myofascial Release, Corrective Exercise, Non Surgical Spinal Decompression, Class IV laser,  and Functional Nutrition.

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