A few months back I wrote a post on how Complimentary and Alternative Medicine can reduce health care costs if implemented more widely instead of suppressed. Insurance companies the state, local, and federal government have all been looking at suppressing chiropractic in order to save costs because they view it as an easy alternative to cutting benefits for over utilized and under performing costlier but more popular options. As I mentioned a few months back the state of Illinois cut chiropractic out of the state medicaid program in order to save costs but at under $7 a visit Illinois would probably save money if they encouraged Medicaid patients to see a chiropractor for their spine condition instead of their doctor or specialists. This brings me to a recent find of mine on pubMed, the place to go to find peer-reviewed health care related studies, that supports my hypothesis that Medicare benefits from chiropractic.
This paper was published in the June 14 2013 edition of the Spine Journal. The authors researched the trends of chiropractic use by medicare beneficiaries from 2002 to 2008. They discovered that utilization of chiropractic by Medicare beneficiaries grew 13% from 2002-2004, remained flat from 2004 -2007, and then declined by 5% from 2007-2008. They estimated that only 6.9% of Medicare beneficiaries utilized chiropractic care in 2008. According to the authors the cost to Medicare grew by 4% through 2005 then dropped by 17% through 2008. While cost to Medicare dropped through 2008 the authors note that there was a growth in overall spending per beneficiary by 10% and an overall increase in Medicare spending by 16% from 2006-2008. The best number these authors report is that payment for chiropractic services account for less than 1/10th of 1 percent of overall Medicare expenditures. In 2008 Medicare paid 420 million for chiropractic services and this number as big as it is, is still less than 1/10th of 1 percent of Medicare expenditures. These numbers help to support a hypothesis of mine regarding Medicare spending and where it can generate savings.
I believe that expanding chiropractic care could result in significant savings to Medicare. When I look at these numbers I see that the number of Medicare beneficiaries who use chiropractic could triple and the cost to Medicare would still be under 5%. If more Medicare patients are receiving care from chiropractors they would not be seeing specialists who would perform costly imaging studies such as and MRI and possibly suggesting costly surgeries or drug therapy. Chiropractic has shown it can be just as or better for spine care than drug therapy and spine surgery, in most instances. While Medicare spending for chiropractic would go up the more costlier care would drop and result in a net savings for Medicare. My ideal is Medicare should promote chiropractic care as the first option or portal of entry for spine care and they would see saving far greater than their current approach.
There are those in the government that think they can save Medicare money by auditing chiropractors because in our past we were bad at documenting, our profession is much better today. These people admit that the care patients received is legitimate but if it was documented poorly they can go after chiropractors and recoup some of that 1/10th of 1 percent that they paid our profession. While fraud does exist it is not as widespread as those in Washington think it is and since our profession is so small, in terms of dollars spent, the amount of truly fraudulent chiropractic claims have to be in the singe digits or fraction of single digits, percentage wise. It is possible that Medicare could spend more money auditing chiropractors than they recoup thus costing us the taxpayer more money.
Today insurance companies and even the government are looking at ways to save money, unfortunately, when it comes to us, their methods are erroneous. Illinois made a big mistake cutting chiropractic from the state Medicaid program last year and Medicare is unfairly targeting our profession when they should be promoting it. The numbers from this study help to support my idea that instead of cutting or punishing chiropractic insurers should promote chiropractic because they would save money while patients get care that, in most cases, more effective than the medical alternatives. If the government really wants to slow the growth of Medicare spending it is my belief that promoting chiropractic is what they need to do.