Recorded presentation

Craig F. Nelson, MS, DC and Kurt Hegetschweiler, DC. Health Services Research, American Specialty Health, 777 Front St., San Diego, CA 92101, 619-405-3658, cnelson19@mn.rr.com

Background: To evaluate the economic impact of chiropractic care it is necessary to both compare the cost per episode of chiropractic and medical care and to determine whether patients use chiropractic care as substitution for medical care or in addition to medical care.

Objective: To evaluate whether patients use chiropractic care as a substitution for medical care or in addition to medical care.

Methods: A retrospective analysis of claims data from a managed care health plan over a four-year period was conducted. Employers could select the managed care plan with or without a chiropractic care benefit. Rates of neuromusculoskeletal complaints in nine diagnostic categories were compared between groups with and without chiropractic coverage.

Results: For the four-year study period there were 3,129,752 insured member years in the groups with chiropractic coverage and 5,197, 686 insured member years in the groups without chiropractic coverage. Expressed in terms of unique patients with NMS complaints the cohort with chiropractic coverage experienced a rate of 162.0 complaints per 1000 member years compared to 171.3 complaints in the cohort without coverage. Expressed in terms of episodes of care of NMS complaints the cohort with coverage experienced 258.2 episodes per 1000 member years vs. 229.6 episodes in the cohort without coverage.

Conclusion: Patients use chiropractic care as a direct substitution for medical care. Chiropractic care results in more episodes of care per patient.

Learning Objectives: At the conclusion of this presentation the participant will

• Understand the issue of substitution vs. add-on care.
• Be able to describe the effects of a chiropractic benefit on rates of NMS complaints in a managed health care plan.

Keywords: Managed Care, Chiropractic

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am employed by the health plan that is the subject of this study.

Recorded presentation