Chiropractic In The News:

JMPT - From the Editor's Desk – Does inclusion of chiropractic care result in cost savings?

by Claire Johnson, DC, MSEd, PhD Editor in Chief – Journal of Manipulative and Physiological Therapeutics | 5/9/2016 10:37:55 AM

The most recent issue of the JMPT has a series of 3 papers that will help to fill the evidence gap and answer the question "Does inclusion of chiropractic care result in cost savings?" Each of these papers focuses on one area of musculoskeletal health that has been identified as a public health burden: low back pain, neck pain, and headache.

We congratulate this amazing team of authors for their outstanding work. Please feel free to share this email and attached papers with those who you feel may benefit from this important information. Happy reading!

Sincerely

Claire Johnson, DC, MSEd, PhD
Editor in Chief – Journal of Manipulative and Physiological Therapeutics


Variations in Patterns of Utilization and Charges for the Care of Headache in North Carolina, 2000-2009: A Statewide Claims’ Data Analysis

Eric L. Hurwitz, DC, PhD, Maria Vassilaki, MD, MPH, PhD, Dongmei Li, PhD, Michael J. Schneider, DC, PhD, Joel M. Stevans, DC, Reed B. Phillips, DC, PhD, Shawn P. Phelan, DC, Eugene A. Lewis, DC, MPH, and Richard C. Armstrong, MS, DC

http://www.jmptonline.org/article/S0161-4754(16)00055-5/abstract

ABSTRACT

Objectives:
The purpose of the study was to compare patterns of utilization and charges generated by medical doctors (MDs), doctors of chiropractic (DCs), and physical therapists (PTs) for the treatment of headache in North Carolina.

Methods:
Retrospective analysis of claims data from the North Carolina State Health Plan for Teachers and State Employees from 2000 to 2009. Data were extracted from Blue Cross Blue Shield of North Carolina for the North Carolina State Health Plan using International Classification of Diseases, Ninth Revision, diagnostic codes for headache. The claims were separated by individual provider type, combination of provider types, and referral patterns.

Results:
The majority of patients and claims were in the MD-only or MD plus referral patterns. Chiropractic patterns represented less than 10% of patients. Care patterns with single-provider types and no referrals incurred the least charges on average for headache. When care did not include referral providers or services, MD with DC care was generally less expensive than MD care with PT. However, when combined with referral care, MD care with PT was generally less expensive. Compared with MD-only care, risk-adjusted charges (available 2006-2009) for patients in the middle risk quintile were significantly less for DC-only care.

Conclusions:
Utilization and expenditures for headache treatment increased from 2000 to 2009 across all provider groups. MD care represented the majority of total allowed charges in this study. MD care and DC care, alone or in combination, were overall the least expensive patterns of headache care. Risk-adjusted charges were significantly less for DC-only care.

(J Manipulative Physiol Ther 2016;39:229-239)

 


Variations in Patterns of Utilization and Charges for the Care of Low Back Pain in North Carolina, 2000 to 2009: A Statewide Claims’ Data Analysis

Eric L. Hurwitz, DC, PhD, Dongmei Li, PhD, Jenni Guillen, MS, Michael J. Schneider, DC, PhD, Joel M. Stevans, DC, Reed B. Phillips, DC, PhD, Shawn P. Phelan, DC, Eugene A. Lewis, DC, MPH, Richard C. Armstrong, MS, DC, and Maria Vassilaki, MD, MPH, PhD

http://www.jmptonline.org/article/S0161-4754(16)00053-1/abstract

ABSTRACT

Objectives:
The purpose of the study was to compare utilization and charges generated by medical doctors (MD), doctors of chiropractic (DC) and physical therapists (PT) by patterns of care for the treatment of low back pain in North Carolina.

Methods:
This was an analysis of low-back-pain-related closed claim data from the North Carolina State Health Plan for Teachers and State Employees from 2000 to 2009. Data were extracted from Blue Cross Blue Shield of North Carolina for the North Carolina State Health Plan using International Classification of Diseases, 9th Revision diagnostic codes for uncomplicated low back pain (ULBP) and complicated low back pain (CLBP).

Results:
Care patterns with single-provider types and no referrals incurred the least charges on average for both ULBP and CLBP. When care did not include referral providers or services, for ULBP, MD and DC care was on average $465 less than MD and PT care. For CLBP, MD and DC care averaged $965 more than MD and PT care. However, when care involved referral providers or services, MD and DC care was on average $1600 less when compared to MD and PT care for ULBP and $1885 less for CLBP. Risk-adjusted charges (available 2006-2009) for patients in the middle quintile of risk were significantly less for DC care patterns.

Conclusions:
Chiropractic care alone or DC with MD care incurred appreciably fewer charges for ULBP than MD care with or without PT care. This finding was reversed for CLBP. Adjusted charges for both ULBP and CLBP patients were significantly lower for DC patients.

(J Manipulative Physiol Ther 2016;39:252-262)

 


Variations in Patterns of Utilization and Charges for the Care of Neck Pain in North Carolina, 2000 to 2009: A Statewide Claims’ Data Analysis

Eric L. Hurwitz, DC, PhD, Dongmei Li, PhD, Jenni Guillen, MS, Michael J. Schneider, DC, PhD, Joel M. Stevans, DC, Reed B. Phillips, DC, PhD, Shawn P. Phelan, DC, Eugene A. Lewis, DC, MPH, Richard C. Armstrong, MS, DC, and Maria Vassilaki, MD, MPH, PhD

http://www.jmptonline.org/article/S0161-4754(16)00054-3/abstract

ABSTRACT

Objectives:
The purpose of the study was to compare utilization and charges generated by medical doctors (MD), doctors of chiropractic (DC) and physical therapists (PT) by provider patterns of care for the treatment of neck pain in North Carolina.

Methods:
This was an analysis of neck-pain-related closed claim data from the North Carolina State Health Plan for Teachers and State Employees (NCSHP) from 2000 to 2009. Data were extracted from Blue Cross Blue Shield of North Carolina for the NCSHP using ICD-9 diagnostic codes for uncomplicated neck pain (UNP) and complicated neck pain (CNP).

Results:
Care patterns with single-provider types and no referrals incurred the least average charges for both UNP and CNP. When care did not include referral providers or services, for either UNP or CNP, MD care with PT was generally less expensive than MD care with DC care. However, when care involved referral providers or services, MD and PT care was on average more expensive than MD and DC care for either UNP or CNP. Risk-adjusted charges for patients in the middle quintile of risk (available 2006-2009) were lower for chiropractic patients with or without medical care or referral care to other providers.

Conclusions:
Chiropractic care alone or DC with MD care incurred appreciably fewer charges for UNP or CNP compared to MD care with or without PT care, when care included referral providers or services. This finding was reversed when care did not include referral providers or services. Risk-adjusted charges for UNP and CNP patients were lower for DC care patterns.

(J Manipulative Physiol Ther 2016;39:240-251)

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