Utilization, Cost, and Effects of Chiropractic
Care on Medicare Program Costs

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

Thanks to the American Chiropractic Association for the use of this material!
Washington, DC, July 2001

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This study examines cost, utilization and effects of chiropractic services on Medicare costs. The study compared program payments and service utilization for Medicare beneficiaries who visited DCs and those who visited other types of physicians. The results indicated that chiropractic care could reduce Medicare costs. Medicare beneficiaries who had chiropractic care had an average Medicare payment of $4,426 for all Medicare services. Those who had other types of care had an average of $8,103 Medicare payment for all Medicare services. The per claim average payment was also lower with chiropractic patients, having an average of $133 per claim compared to $210 per claim for individuals who did not have chiropractic care.

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NEW STUDY PROVIDES PROOF OF CHIROPRACTIC'S COST-SAVING IMPACT
ON MEDICARE PROGRAM

A new study of Medicare cost data completed in June by the well-known Washington, DC-based firm Muse & Associates helps prove the cost-saving impact that chiropractic care has on the current federal Medicare program. The study, titled "Utilization, Costs, and Effects of Chiropractic Care on Medicare Program Costs," was commissioned by the ACA and is the first study of its type to compare the global, per capita Medicare expenditures of chiropractic patients to those of non-chiropractic patients receiving care in the federal Medicare program. The study utilizes data obtained from Medicare's Standard Analytical Files for 1999--the most recent year cost data is available for analysis.

The study's executive summary states:

"The results strongly suggest that chiropractic care significantly reduces per beneficiary costs to the Medicare program. The results also suggest that Chiropractic services could play a role in reducing costs of Medicare reform and/or a new prescription drug benefit."

The study specifically found that:

1. beneficiaries who received chiropractic care had lower average Medicare payments for all Medicare services than those who did not ($4,426 vs. $8,103);
   

2. beneficiaries who received chiropractic care averaged fewer Medicare claims per capita than those who did not; and
   

3. beneficiaries who received chiropractic care had lower average Medicare payments per claim than those who did not.

According to ACA officials, the positive results of the study will be used to bolster ACA's legislative efforts to expand the availability of chiropractic care in Medicare and to expand the list of chiropractic-related services the Medicare program would reimburse.

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A summary of the report prepared by Muse and Associates
for the American Chiropractic Association

Chiropractic care significantly reduces per beneficiary costs to the Medicare program and could potentially save the program even more money in the future, according to a report recently released by Muse and Associates, an actuarial consulting firm based in Washington, DC. The study was commissioned by the American Chiropractic Association (ACA) to research and document the cost-effectiveness of chiropractic care in the Medicare system.

The report found significant differences in the utilization of services and Medicare payment for beneficiaries who saw doctors of chiropractic versus those who did not. The report has not been finalized, so detailed information is not available yet. The report must go through a long approval process, including the Centers for Medicare and Medicaid Services' (CMS), formerly known as the Health Care Financing Administration, review of the data. As soon as the Muse report is final, the ACA will make it available.

The report utilized data compiled by the CMS, and focuses on Medicare beneficiaries with primary diagnoses of selected musculoskeletal, dislocations, sprains and strains of joints and adjacent muscle conditions. The data, derived from CMS'1999 figures, indicates that approximately 5.8 million beneficiaries had a Medicare claim with a principal diagnosis of at least one of the selected medical conditions listed above. Of these individuals, about 1.5 million (26.8 percent) received chiropractic care and 4.3 million (73.2 percent) were treated by other types of providers.

The report's conclusion suggests that decreased access to chiropractic services
would increase the Medicare program's costs.

In addition, the report found that, overall, beneficiaries who used chiropractic services
had lower medical doctor costs.

Due to these cost savings, the report suggests that during any congressional debate on Medicare reform,
consideration should be given to providing increased access to chiropractic care.

In addition, the study suggests that some savings would probably accrue in the Medicare program if
access to chiropractic services were increased in concert with a Medicare prescription drug benefit.

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Since 6-01-2001