Why Health Care Costs for LBP Are So High

Initiating care with an MD for back pain results in much higher health care costs than going to a DC, says study.

By Peter W. Crownfield

With the much-touted Choudhry/Milstein study already putting insurers and other health care stakeholders on notice that chiropractic care for back pain “is highly cost-effective [and] represents a good value in comparison to medical physician care and to widely accepted cost-effectiveness thresholds,” along comes “Cost of Care for Common Back Pain Conditions Initiated With Chiropractic Doctor vs. Medical Doctor / Doctor of Osteopathy as First Physician.”

Published in the December 2010 issue of JMPT, the study, a retrospective claims analysis of Blue Cross Blue Shield of Tennessee’s intermediate and large group fully insured population, determined that paid costs for episodes of care were 40 percent lower when care was initiated with a doctor of chiropractic compared to an allopathic provider. Even when risk-adjusting each patient’s costs to account for severity, paid costs for chiropractic patients were 20 percent lower than medical patients treated for low back pain.

“Our results support a growing body of evidence that chiropractic treatment of low back pain is less expensive than traditional medical care,” stated the study authors in their conclusion. “We found that episode cost of care for LBP initiated with a DC is less expensive than care initiated through an MD. … Our results suggest that insurance companies that restrict access to chiropractic care for LBP may, inadvertently, be paying more for care than they would if they removed these restrictions.”

Health Care Cost In their study, the researchers identified Blue Cross Blue Shield of Tennessee members with an LBP claim based on the presence of any of the following ICD-9 codes on a paid claim: 722 Intervertebral disk disorders, 724 Other and unspecified disorders of back, 729 Other disorders of soft tissues, 739 Nonallopathic lesions not elsewhere classified, 846 Sprains and strains of sacroiliac region, and 847 Sprains and strains of other and unspecified parts of back. Of more than 650,000 members during the two-year period analyzed (Oct. 1, 2004 – Sept. 30, 2006), 85,402 had been diagnosed using one of the above codes.

Plan members had open access to MDs and DCs through self-referral (ER visits were categorized as MD-initiated care), without any limit to the number of visits. Co-pays did not vary between provider type.

Total episode costs for each episode of LBP were determined by calculating the cost paid by the insurer for all services provided during the episode by the same and other providers. Costs per episode were $452.33 (paid) for patients initiating care with a chiropractor and $1,037.04 for patients initiating care with a medical provider; risk-adjusted paid costs were $532.54 (DC) vs. $661.10 (MD).

“As doctors of chiropractic, we know firsthand that our care often helps patients avoid or reduce more costly interventions such as drugs and surgery. This study supports what we see in our practices every day,” said ACA President Rick McMichael, DC, in an ACA release reporting on the study findings. “It also demonstrates the value of chiropractic care at a critical time, when our nation is attempting to reform its health care system and contain runaway costs.”

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Nearly 30,000 Get Cancer EVERY Year in the US from this…

This is an excerpt from http://emf.mercola.com/sites/emf/archive/2010/09/25/high-ct-scan-radiation-is-deadly.aspx. It really shows further evidence why health care comsumers must stay on top of what is recommended. To read the entire article follow the link.

This year, one in every 10 Americans will have a CT scan (computed tomography).

The amount of money spent on medical imaging doubled between 2000 and 2006 to about $14 billion a year—and that is just Medicare alone, according to a study by the Government Accountability Office.

More than 70 million CT scans per year are now performed in the US, including at least 4 million on children. This is up from just 3 million in 1980.

Nearly 30,000 Get Cancer EVERY Year in the US from CT Scans

According to a study in the Archives of Internal Medicine last year, CT scans alone will cause nearly 30,,000 unnecessary cancer cases (about 2 percent of cancer cases), which will lead to about 14,500 deaths.

But wait, there’s more bad news.

While 30,000 cancer cases is a large number, a New England Journal of Medicine study from 2007 estimated that overuse of diagnostic CT scans may cause up to 3 million excess cancers over the next 20 to 30 years.

For those slow on math that is 1,00X more deaths over the next 25 years.

David Brenner of Columbia University, lead author of the study, told USA Today:

“About one-third of all CT scans that are done right now are medically unnecessary … Virtually anyone who presents in the emergency room with pain in the belly or a chronic headache will automatically get a CT scan. Is that justified?”

Why are so many CT scans being done, when they result in so many unnecessary deaths?

There are several reasons:

  • Physicians fear being sued for malpractice if they miss something.
  • Some patients pressure their physicians for scans “just to be safe,” especially after hearing advertisements touting the benefits of new hi-tech tests (without disclosure of the risks).
  • Physicians are more often using scans to screen “the worried well” (such as scanning former smokers for lung cancer).
  • Many doctors have purchased their own imaging equipment for their practices. This adds a financial incentive into the mix and sets the stage for overuse of the technology.
  • There’s a trend toward commercially advertised full-body CT scans to “find everything wrong with you.” Consumers with extra cash lying around (in excess of $1,000 in most cases) are being encouraged to undergo a full-body scan as a preventive measure.

While high-tech imaging can be beneficial in certain cases, it must be used SPARINGLY because it exposes your body to dangerous radiation—radiation that is proven to cause cancer.

And you are being exposed to more radiation from your diagnostic test than was previously thought. Studies have recently found that radiation doses from CT scans tend to be higher than the amounts generally reported.

When the diagnostic procedure causes the disease you are trying to avoid, perhaps you should reconsider the procedure!

Becoming aware of the risks of medical scans is part of becoming a smart consumer and knowing your health care options. Research suggests that a dismal seven percent of patients are informed of the risks of CT scans.

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