chiro coverBack pain costs over $100 billion per year in the United States. It is the second leading cause for doctor visits and hospitalizations. Research that appeared in the Archives of Internal Medicine (2004;164:1985-1992) looked at the affect having chiropractic included in a health insurance policy had on the cost of health care.

The study compared costs  of 700,000 health plan members with chiropractic coverage to a million members with the same health coverage minus the chiropractic care. The members with chiropractic coverage had lower annual costs than those with policies that did not include chiropractic care   ($1463 vs $1671 per member per year). Having chiropractic coverage was associated witha 1.6% decrease in total annual health care costsat the health plan level. Back pain patients with chiropracticcoverage, compared with those without coverage, had fewer x-rays  (17.5 vs 22.7),less low back surgery (3.3 vs 4.8), fewer hospitalizations (9.3vs 15.6), and fewer MRIs  (43.2 vs68.9). Patients with chiropractic coverage, comparedwith those without coverage, also had lower average back painepisode–related costs ($289 vs $399).

Conclusions  Access to managed chiropractic care may reduce overall health care costs through several effects, including(1) positive risk selection; (2) substitution of chiropracticfor traditional medical care, particularly for spine conditions;(3) more conservative, less invasive treatment profiles; and(4) lower health service costs associated with managed chiropracticcare. Systematic access to managed chiropractic care not onlymay prove to be clinically beneficial but also may reduce overall health care costs.

From the Department of Health Services, UCLA School of Public Health, Los Angeles, Calif (Dr Legorreta); American Specialty Health Plans, San Diego, Calif (Drs Metz and Nelson); Health Benchmarks Inc, Woodland Hills, Calif (Drs Ray and Chernicoff); and Department of Orthopedic Surgery, Hospital of the University of Pennsylvania, Philadelphia (Dr DiNubile). Dr Metz is a corporate officer of American Specialty Health Plans.