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5/4/2020 Member News

Chiropractic Care Needs Higher Reimbursement from Government and Private Insurance

By Craig Benton, DC
TCA Scientific Affairs Coordinator

An article in the March 2020 issue of the Journal of the American Medical Association noted that lower back and neck pain were now the most expensive conditions to treat in the United States. Lower back and neck pain have leapfrogged over diabetes and heart disease as the most expensive conditions to treat. The paper suggests that the increased use of advanced imaging, not to mention specialty care such as pain management and surgery, have driven costs way up.  Chiropractic care does NOT fall into those categories.

Two years ago, the medical journal Lancet suggested that lower back pain was now the most disabling disease in the U.S. and the world.  Lower back disability has increased over 50% since 1990. While more people die from heart disease, more people live with years lived with disability (YLDs) with lower back pain than any other condition. Back pain won’t kill you, but it just might feel like it does.

These same experts, in the same medical journals, are recommending non-pharmacological care first before any other type of treatment is performed.  These same journals are recommending spinal manipulation as one of the first treatments to implement before other treatments. Sadly, research also indicates that, when a patient goes to a medical doctor for these conditions, less than 20% get evidenced-based care. It is my opinion that this is a reason why the healthcare costs and disabilities have risen in recent years.

Chiropractic care is currently considered a high-value/low-cost care. What does that mean?  Compared to other types of care for lower back pain, our costs are generally low.  Also, they are of high value, which I don’t think we promote enough. High-value care is effective care, efficient care, and has a high level of patient satisfaction. This is especially true when compared to spinal injections, which are low-value and high costs.  Fusion spinal surgery also is high-cost and low-value.  The problem is government and insurance seem to reimburse low-value care much better than high-value. Reimbursing these low-value care options is causing an increase in costs and disability.

Each year, I have seen my reimbursement for spinal manipulation decrease from insurance.  It is time we stand and fight the battle to increase our reimbursement to acceptable levels.  It will not be an easy battle, but it is necessary.  To do nothing will cause increase patient pain and suffering.

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