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