A Comparison of Health Care Costs
for Chiropractic and Medical Patients

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

FROM:   J Manipulative Physiol Ther 1993 (Jun); 16 (5): 291–299

Miron Stano, PhD

School of Business Administration,
Oakland University,
Rochester, MI 48039-4401

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The Stano Cost Comparison Study Miron Stano, PhD, a health care economist at Oakland University, conducted a study comparing the health-care costs for chiropractic and medical patients with neuromusculoskeletal conditions. The database he used came from the records of MEDSTAT Systems, Inc., a health benefits management consulting firm which processes insurance claims for many of the country's largest corporations. This June 1993 Journal of Manipulative and Physiological Therapeutics study involved 395,641 patients, drawn from statistical information on more than two million beneficiaries. Results over a two-year period showed that patients who received chiropractic care incurred significantly lower health care costs than did patients treated solely by medical or osteopathic physicians. DISTRIBUTION OF TOTAL COST PER CASE FOR SELECTED ICD-9 CODES (MEAN VALUES)  ICD-9 CODE DIAGNOSIS TOTAL COST (MEDICAL) TOTAL COST (CHIROPRACTIC) 722.10 Lumbar Disc $  8,175 $  1,065 724.40 Neuritis/Radiculitis $  2,154 $     531 846.00 Sprain/Sacroiliac $     813 $     537 847.00 Sprain/Strain Cervical $     968 $     586 847.10 Sprain/Strain Thoracic $     487 $     474 847.20 Sprain/Strain Lumbar $     969 $     523 Total Cost of Selected Cases $ 13,556 $  3,716 Average Cost Per Case $  2,259 $    619 Also of interest, for those patients receiving both medical and chiropractic care, the Stano/MEDSTAT results revealed: 31 percent lower hospital admissions rates; 43 percent lower inpatient payments; and 23 percent lower total health care costs.

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OBJECTIVE:   To compare the health care costs of patients who have received chiropractic treatment for common neuromusculoskeletal disorders with those treated solely by medical and osteopathic physicians.

DESIGN:   Retrospective statistical analysis of 2 yr of claims data on various categories of utilization and insurance payments for a large national sample of patients.

SETTING:   Ambulatory and inpatient care.

PATIENTS:   A total of 395,641 patients with one or more of 493 neuromusculoskeletal ICD-9 codes.

OUTCOME MEASURES:   Hospital admission rates and 10 categories of insurance payments.

RESULTS:   Nearly one-fourth of patients were treated by chiropractors. Patients receiving chiropractic care experienced significantly lower health care costs as represented by third party payments in the fee-for-service sector. Total cost differences on the order of $1,000 over the 2-yr period were found in the total sample of patients as well as in subsamples of patients with specific disorders. The lower costs are attributable mainly to lower inpatient utilization. The cost differences remain statistically significant after controlling for patient demographics and insurance plan characteristics.

CONCLUSIONS:   Although work is in progress to control for possible variations in case mix and to compare outcomes in addition to costs, these preliminary results suggest a significant cost-saving potential for users of chiropractic care. The results also suggest the need to reexamine insurance practices and programs that restrict chiropractic coverage relative to medical coverage.

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