Cost Minimization Analysis of Low Back Pain Claims Data for Chiropractic Vs Medicine in a Managed Care Organization

Grieves, Brian; Menke, J. Michael; Pursel, Kevin J.

doi:10.1016/j.jmpt.2009.10.001

Cited by 19 publications

(23 citation statements)

References 17 publications

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“…The biggest concentration of full economic evaluations (19 in number) pertained to the use of NCCAM's definition of manipulative and body-based practices (eg, chiropractic, osteopathic manipulation, massage, etc) for the treatment of back pain. [53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72] However, even this subgroup is fairly heterogeneous in terms of the therapy (or therapies) tested and/or the type of back pain treated. Eight of these comparisons involved chiropractic care for back pain; one for chronic, 53 one for acute 57 and six for either type.…”

Section: Unit Of Health Outcome Monetary Units (Eg Us$) Natural Unitmentioning

confidence: 99%

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

et al. 2012

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ObjectiveA comprehensive systematic review of economic evaluations of complementary and integrative medicine (CIM) to establish the value of these therapies to health reform efforts.Data sourcesPubMed, CINAHL, AMED, PsychInfo, Web of Science and EMBASE were searched from inception through 2010. In addition, bibliographies of found articles and reviews were searched, and key researchers were contacted.Eligibility criteria for selecting studiesStudies of CIM were identified using criteria based on those of the Cochrane complementary and alternative medicine group. All studies of CIM reporting economic outcomes were included.Study appraisal methodsAll recent (and likely most cost-relevant) full economic evaluations published 2001–2010 were subjected to several measures of quality. Detailed results of higher-quality studies are reported.ResultsA total of 338 economic evaluations of CIM were identified, of which 204, covering a wide variety of CIM for different populations, were published 2001–2010. A total of 114 of these were full economic evaluations. And 90% of these articles covered studies of single CIM therapies and only one compared usual care to usual care plus access to multiple licensed CIM practitioners. Of the recent full evaluations, 31 (27%) met five study-quality criteria, and 22 of these also met the minimum criterion for study transferability (‘generalisability’). Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM therapy versus usual care. Study quality of the cost-utility analyses (CUAs) of CIM was generally comparable to that seen in CUAs across all medicine according to several measures, and the quality of the cost-saving studies was slightly, but not significantly, lower than those showing cost increases (85% vs 88%, p=0.460).ConclusionsThis comprehensive review identified many CIM economic evaluations missed by previous reviews and emerging evidence of cost-effectiveness and possible cost savings in at least a few clinical populations. Recommendations are made for future studies.

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Section: Unit Of Health Outcome Monetary Units (Eg Us$) Natural Unitmentioning

confidence: 99%

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

et al. 2012

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“…The management was concerned that if the maximum payment was too low, DCs would shift management of cases to medical providers and the previously proven cost savings would be lost. 11 To determine what the maximum fee-for-service payment should be, a survey of the annual average of approved charges for the contracted DCs was reviewed. The maximum payment will be set at the level that the least expensive 20% of DCs were collecting annually.…”

Section: Resultsmentioning

confidence: 99%

“…11 Overriding any change, however, management demanded predictability of cost. However, quality and best practices were to be the catalysts.…”

Section: Discussionmentioning

confidence: 99%

“…11 To better manage treatment intensity, length, and procedure utilization for DCs, HMO management provided regular feedback to the contracted DCs with exposure to best-practice data, annual formal education in critical assessment of current clinical management strategies, and, if necessary, individual coaching to contracted DCs who were especially costly to the HMO. Arise Health Plan offered additional compensation to DCs who achieved the National Committee for Quality Assurance-Back Pain Recognition Program (NCQA-BPRP) recognition status.…”

Section: Methodsmentioning

confidence: 99%

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Paying for Quality Not Quantity: A Wisconsin Health Maintenance Organization Proposes an Incentive Model for Reimbursement of Chiropractic Services

Pursel¹,

Jacobson²,

Stephenson³

2012

Journal of Manipulative and Physiological Therapeutics

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“…[13][14][15] Why it is important to perform this review Previous studies have provided sufficient evidence on the effectiveness and safety of manual therapy but insufficient evidence on cost-effectiveness. [16][17][18][19][20][21][22][23][24][25][26][27][28] Therefore, a comprehensive review to identify and evaluate trial-based economic evidence for manual therapy relative to other alternative interventions used for musculoskeletal diseases would be useful. Although the subject has been reviewed by Tsertsvadze et al 6 who searched up to February 2013, the present study extends the review by including new studies published since February 2013 and studies from Chinese and Korean databases.…”

Section: Introductionmentioning

confidence: 99%

Economic evaluation of manual therapy for musculoskeletal diseases: a protocol for a systematic review and narrative synthesis of evidence

et al. 2016

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IntroductionManual therapy is the non-surgical conservative management of musculoskeletal disorders using the practitioner's hands on the patient's body for diagnosing and treating disease. The aim of this study is to systematically review trial-based economic evaluations of manual therapy relative to other interventions used for the management of musculoskeletal diseases.Methods and analysisRandomised clinical trials (RCTs) on the economic evaluation of manual therapy for musculoskeletal diseases will be included in the review. The following databases will be searched from their inception: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Econlit, Mantis, Index to Chiropractic Literature, Science Citation Index, Social Science Citation Index, Allied and Complementary Medicine Database (AMED), Cochrane Database of Systematic Reviews (CDSR), National Health Service Database of Abstracts of Reviews of Effects (NHS DARE), National Health Service Health Technology Assessment Database (NHS HTA), National Health Service Economic Evaluation Database (NHS EED), CENTRAL, five Korean medical databases (Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Service System (RISS), DBPIA, Korean Traditional Knowledge Portal (KTKP) and KoreaMed) and three Chinese databases (China National Knowledge Infrastructure (CNKI), VIP and Wanfang). The evidence for the cost-effectiveness, cost-utility and cost-benefit of manual therapy for musculoskeletal diseases will be assessed as the primary outcome. Health-related quality of life and adverse effects will be assessed as secondary outcomes. We will critically appraise the included studies using the Cochrane risk of bias tool and the Drummond checklist. Results will be summarised using Slavin's qualitative best-evidence synthesis approach.Ethics and disseminationThe results of the study will be disseminated via a peer-reviewed journal and/or conference presentations.Trial registration numberPROSPERO CRD42015026757.

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Cost Minimization Analysis of Low Back Pain Claims Data for Chiropractic Vs Medicine in a Managed Care Organization

Cited by 19 publications

References 17 publications

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

Paying for Quality Not Quantity: A Wisconsin Health Maintenance Organization Proposes an Incentive Model for Reimbursement of Chiropractic Services

Economic evaluation of manual therapy for musculoskeletal diseases: a protocol for a systematic review and narrative synthesis of evidence

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