Cost Minimization Analysis of Low Back Pain Claims Data for Chiropractic Vs Medicine in a Managed Care Organization
Received 12 December 2007; received in revised form 25 September 2009; accepted 25 September 2009.
Abstract
Objective
A managed care organization (MCO) examined differences in allowed cost for managing low back pain by medical providers vs chiropractors in an integrated care environment. The purpose of this study is to provide a retrospective cost analysis of administrative data of chiropractic vs medical management of low back pain in a managed care setting.
Methods
All patients with a low back pain–related diagnosis presenting for health care from January 2004 to June 2004 who were insured by an MCO in northeast Wisconsin were tracked. The cumulative health care costs incurred by this MCO during the 2-year period from January 2004 to December 2005 related to these back pain diagnoses were collected.
Results
Allowed costs of chiropractic treatment were 12% greater than medical primary care and 60% less per case than other types of medical care combined, on a per-case basis: median cost of medical primary care was $365.00, chiropractic care was $417.00, and medical nonprimary care was $669.00.
Conclusion
This study of an MCO's low back pain allowed costs may be better redirected to primary care or chiropractic, given equivalent levels of case complexity. This study suggests chiropractic management as less expensive compared with medical management of back pain when care extends beyond primary care. Primary care management alone is virtually indistinguishable from chiropractic management in terms of costs.
aChiropractic Private Practice, Grieves Chiropractic Pain Relief Clinic, Shawano Medical Center Rehab Services, Shawano, Wis
bResearch Fellow, Program in Integrative Medicine & Department of Psychology, University of Arizona, Tucson, Ariz
cDirector of Chiropractic Services, Arise Health Plan, Green Bay, Wis
Submit requests for reprints to: Brian Grieves, DC, MPH, Grieves Chiropractic Pain Relief Clinic, Shawano Medical Center Rehab Services, 116 N Main Street, Shawano, WI 54166
ABSTRACT