Medicare Gives Chiropractic High Marks

Medicare Patients Give Chiropractic High Marks

Results from demonstration project suggest feasibility of expanding chiropractic services in the Medicare program.

By Peter W. Crownfield, Executive Editor

The long-awaited final report on the Centers for Medicare & Medicaid Services (CMS) chiropractic demonstration project, conducted from April 2005 through March 2007, is good news for chiropractic, with 87 percent of patients surveyed giving their doctor of chiropractic a score of 8 or higher when asked to rate their satisfaction with care (1-10 scale), and 56 percent rating their chiropractor a perfect 10.

The demonstration project, “Demonstration of Coverage for Chiropractic Services Under Medicare,” evaluated the effects of expanding coverage of chiropractic services in four different regions of the country: Maine, New Mexico, 26 counties in northern Illinois and one county (Scott) in Iowa, and 17 counties in rural Virginia. Approximately 40 percent of eligible DCs in the four regions participated in the project at some point or another.

Key findings from the summary report, relative to patient experiences with chiropractic care and analysis of chiropractic-specific Medicare costs during the project, include the following.

  • “Medicare beneficiaries reported good relief of symptoms and high degrees of satisfaction with the chiropractic care they received.”
  • “The most frequent reasons given for seeking care from chiropractors were favorable earlier experiences (59 percent) and insufficient relief of symptoms by prior treatments of other health professionals (39 percent).”
  • “Clinical problems involved the back in 78 percent, neck in 50 percent, hip in 38 percent, and shoulder in 32 percent. Pain was the most frequent symptom, followed by difficulty walking. … Sixty percent of [survey] respondents indicated that they received ‘complete’ or ‘a lot of’ relief of symptoms from their chiropractic treatments.”
  • “Chiropractic care was felt to be easily accessible, and nearly 95 percent of respondents indicated that they had to wait no more than one week for appointments. Similarly high proportions reported that chiropractors listened carefully and spent sufficient time with them.”

The stated purpose of the demonstration project was “for evaluating the feasibility and advisability of covering chiropractic services under the Medicare program (in addition to the coverage provided for services consisting of treatment by means of manual manipulation to the spine to correct a subluxation described in section 1861(r)(5) of the Social Security Act.” Chiropractic was defined as “care for neuromusculoskeletal conditions typical among eligible beneficiaries and diagnostic and other services that a chiropractor is legally authorized to perform by the State or jurisdiction in which such treatment is provided.” Chiropractic care needed to conform with CMS’s policy for reimbursement of chiropractic services, meaning treatment was for active conditions with reasonable expectation of improvement or resolution. Maintenance and prevention services were excluded per the CMS policy.

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