Back pain costs the U.S. healthcare system more than $100 billion per year and is the second leading cause of physician visits and hospitalizations. Research published in the Archives of Internal Medicine (2004;164:1985–1992) examined whether including chiropractic care in health insurance plans affected overall healthcare costs.
The study compared approximately 700,000 health plan members with chiropractic coverage to one million members with similar coverage that excluded chiropractic care. Members with chiropractic coverage had lower annual healthcare costs than those without coverage ($1,463 vs. $1,671 per member per year). At the health plan level, chiropractic coverage was associated with a 1.6% reduction in total annual healthcare costs.
Among patients with back pain, those with chiropractic coverage experienced:
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Fewer X-rays (17.5 vs. 22.7)
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Less low back surgery (3.3 vs. 4.8)
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Fewer hospitalizations (9.3 vs. 15.6)
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Fewer MRIs (43.2 vs. 68.9)
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Lower episode-related back pain costs ($289 vs. $399)
The authors concluded that access to managed chiropractic care may reduce healthcare costs through several mechanisms, including substitution of chiropractic care for more invasive medical interventions, more conservative treatment approaches, and lower utilization of high-cost imaging and surgical procedures.
The authors also noted that cost reductions may reflect factors such as patient selection and care pathways, and emphasized that systematic access to chiropractic care may offer both economic and clinical advantages within managed care settings.
