The Role of Chiropractic Care in the Patient-Centered Medical Home

This newly released hallmark paper documents the value of chiropractic care in the next phase of healthcare delivery. Prepared by the leading consulting firm, DISCERN, this document details the many opportunities for a Chiropractic Doctor to be a fundamental figure within the medical home model. By integrating chiropractic care, medical home care teams are able to effectively care for patients, and therefore meet the criteria and goals of the Patient-Centered Medical Home - - improved overall health outcomes - - affordable healthcare, better access and increased patient satisfaction.

Click Here to attain your copy, which can serve as an educational piece and/or a starting point for securing your position as a Doctor of Chiropractic within the medical home.

Health Maintenance Care in Work-Related Low Back Pain and Its Association With Disability Recurrence

Low back pain (LBP) continues to be one of the costliest work-related injuries in the United States in terms of disability and treatment costs. New research, conducted by medical and healthcare professionals outside the chiropractic profession, compared the occurrence of repeated disability episodes across types of health care providers who treat claimants with new episodes of work-related low back pain (LBP). The overall conclusion was the use of health maintenance care provided by physical therapist or physician services was associated with a higher disability recurrence than in chiropractic services or no treatment.

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Manipulation or Microdiskectomy for Sciatica? A Prospective Randomized Clinical Study

In a recent study, "Manipulation or Microdiskectomy for Sciatica? A Prospective Randomized Clinical Study", spinal manipulation was found to be just as effective as microdiskectomy for patients struggling with sciatica secondary to lumbar disk herniation (LDH). The patient population studied included people experiencing chronic sciatica (symptoms greater than six months) that had failed traditional, medical management. Overall, 60 percent of patients who received spinal manipulation benefited to the same degree as those who underwent surgery.

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Neck Pain Study

Results of the most significant study on neck pain to date, conducted by The World Health Organization's Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders, and reported in the journal SPINE (1/18/08), uncover prevailing fallacies in the diagnosis and treatment of neck.

The study results stem from a six-year review of more than 31,000 research citations with subsequent analysis of over 1,000 studies. The multi-disciplinary report, based on research spanning seven years by clinicians and scientist from multiple clinical and scientific disciplines, is widely regarded as one of the most extensive reports on the subject of neck pain ever developed.

Scott Haldeman, DC, MD, PhD, President of the Bone and Joint Decade Task Force, wrote in 2010, "there is now little dispute amongst knowledgeable scientists that manipulation is of value in the management of back pain, neck pain and headaches that make up 90% or more of all patients who seek chiropractic care".

To learn more, please click here: Neck Pain

Cost Effectiveness

A study conducted from 1999-2002 concluded that complementary and alternative medicine-orientated primary care physicians who used a nonsurgical and nonpharmaceutical approach demonstrated reductions in both clinical and cost utilization when compared with primary care physicians using conventional medicine alone.

Due to the significance of the findings, the study was extended from 2003-2005 to obtain a larger population of results than originally reported. As expected, the results found decreased utilization (and consequent cost savings) by all complementary and alternative practitioners, including doctors of chiropractic acting in a primary care role.

The full report can be downloaded here: Cost Effectiveness

Evidence Based Assessment

An Evidence-Based Assessment of Increment Impact on Population Health and Total Health Care Spending

Low back and neck pain are extremely common conditions that consume large amounts of health care resources. Chiropractic care, including spinal manipulation and mobilization, is used by almost half of US patients with persistent back-pain. Does the availability of chiropractic care improve the value of health benefits plans?

A report, prepared by a global leader for trusted human resources and related financial advice, products and services, finds that the addition of chiropractic care for the treatment of low back and neck pain will likely increase value-for-dollar in US employer-sponsored health benefit plans. Authored by Niteesh Choudhry, MD, PhD, and Arnold Milstein, MD, the report can be fully downloaded at: Full Report

Cam Benefit

Back pain is the second most common reason patients seek ambulatory medical care in the United States. Complementary and Alternative Medicine (CAM) is used by 40% to 60% of the population yearly, and back pain is the most common medical condition for which people use CAM. Using a nationally representative survey, analysis shows that the majority of respondents who used CAM for back pain perceived great benefit and identified specific factors associated with perceived benefit.

The full report which was published in the May-June 2010 issue of the Journal of the American Board of Family Medicine can be downloaded by Clicking Here.

Evidenced Based - CHVI

The Center for Health Value Innovation unveiled their ground-breaking contracting mechanism, Outcomes-Based Contracting, an approach that transforms health benefit design. Outcomes-Based Contracting (OBC) recognizes value-based benefit design (VBBD) as a superior engagement tool for aligning the delivery system with the goals of the payer to drive accountable care, enhanced health status and cost efficiency. Outcomes-Based Contracting emerges as the only sensible contracting mechanism to move the system away from commodity pricing and into measurable, meaningful outcomes.

Following their initial authoritative paper detailing the contracting method, they released a landmark document, Outcomes-Based Contracting: The Value-Based Approach for Optimal Health with Chiropractic Services, which points to chiropractic intervention as one area in which new analysis may define the placement in the care continuum.

The report is the direct result of the findings in a 2009 study (Do Chiropractic Physician Services for Treatment of Low Back and Neck Pain Improve the Value of Health Benefit Plans), authored by Arnold Milstein, MD (Mercer Health and Benefits) and Niteesh Choudhry, MD, PhD (Harvard Medical School), which validates chiropractic care as an effective and affordable form of treatment for low back and neck pain.

The CHVI analysis found there is sufficient basis for plan sponsors to reevaluate their current chiropractic benefit for treatment of neck and low back pain, and provides the framework for incorporating chiropractic services for low back and neck pain into a value-based benefit design in order to derive the best health value for the payer and patient.