Abstract
Objective
The primary aim of this study was to determine if there are differences in the cost
of low back pain care when a patient is able to choose a course of treatment with
a medical doctor (MD) versus a doctor of chiropractic (DC), given that his/her insurance
provides equal access to both provider types.
Methods
A retrospective claims analysis was performed on Blue Cross Blue Shield of Tennessee’s
intermediate and large group fully insured population between October 1, 2004 and
September 30, 2006. The insured study population had open access to MDs and DCs through
self-referral without any limit to the number of visits or differences in co-pays
to these 2 provider types. Our analysis was based on episodes of care for low back
pain. An episode was defined as all reimbursed care delivered between the first and
the last encounter with a health care provider for low back pain. A 60 day window
without an encounter was treated as a new episode. We compared paid claims and risk
adjusted costs between episodes of care initiated with an MD with those initiated
with a DC.
Results
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, we found that
episodes of care initiated with a DC were 20% less expensive than episodes initiated
with an MD.
Conclusions
Beneficiaries in our sampling frame had lower overall episode costs for treatment
of low back pain if they initiated care with a DC, when compared to those who initiated
care with an MD.
Key Indexing Terms
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Article info
Publication history
Published online: October 21, 2010
Accepted:
June 8,
2010
Received in revised form:
May 20,
2010
Received:
March 24,
2010
Identification
Copyright
© 2010 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.
