The Research

Cost Effectiveness

Low back pain initiated with a doctor of chiropractic (DC) saves 40 percent on health care costs when compared with care initiated through a medical doctor (MD), according to a study that analyzed data from 85,000 Blue Cross Blue Shield (BCBS) beneficiaries in Tennessee over a two-year span. The study population had open access to MDs and DCs through self-referral, and there were no limits applied to the number of MD/DC visits allowed and no differences in co-pays. Researchers estimated that allowing DC-initiated episodes of care would have led to an annual cost savings of $2.3 million for BCBS of Tennessee. They also concluded that insurance companies that restrict access to chiropractic care for low back pain treatment may inadvertently pay more for care than they would if they removed such restrictions. (5)

“The average cost of [low back injury] claims is $15,884. When a worker with a lower back injury receives at least 75% of his/her care from a chiropractor, that cost decreases to $12,202 and when he/she receives at least 90% of their care from a chiropractor the average cost declines even further to $7,632.” (8)

“Chiropractic care appeared relatively cost-effective for the treatment of chronic low-back pain. Chiropractic and medical care performed comparably for acute patients. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulative efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapeusis.” (9)

More Research

You can find more research here that includes information on the following: public opinion, reduction in costs, outcomes and efficacy, and prevalence.

The Results

“Reduced odds of surgery were observed for…those whose first provider was a chiropractor. 42.7% of workers [with back injuries] who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor.” (6) 

Studies comparing health insurance payments and patient utilization patterns of individuals suffering from recurring low back pain who visited DCs or MDs demonstrated that those who visited chiropractors paid less and were more satisfied with the care given. The study suggests that chiropractic care should be given careful attention by employers when using gate-keeper strategies. (10)

“Acute and chronic chiropractic patients experienced better outcomes in pain, functional disability, and patient satisfaction; clinically important differences in pain and disability improvement were found for chronic patients.” (9)






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“Evidence of Clinical and Cost-Effectiveness of Chiropractic Spinal Manipulation”