Project for Integrative Health and the Triple Aim (PIHTA) - Knowledge Base

Third Party Payers/Insurers

The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems
Martin BI, Gerkovich MM, Deyo RA, Sherman KJ, Cherkin DC, Lind BK, Goertz CM, Lafferty WE

Data from a national health survey (Medical Expenditure Panel Survey) was used to analyze the cost differential between CAM and non-CAM users seeking care for spinal problems. Primary outcome measures showed a lower annual cost and better overall health status for CAM users compared to non-CAM users.

Cost Minimization Analysis of Low Back Pain Claims Data for Chiropractice Vs. Medicine in a Managed Care Organization
Brian Greves, Michael Menke, Kevin Pursel

Retrospective cost analysis comparing chiropractic care and medical management for patients with low back pain. Results suggest that chiropractic management is less costly than medical management of LBP for cases that advance outside of primary care.

Clinical Utilization and Cost Outcomes from an Integrative Medicine and Independent Physician Association: An additional 3-year Update
Richard Sarnat, James Winterstein, Jerrilyn Cambron

This study spanning over 7 years of shows that cost outcomes for integrative medicine can be below those of traditional medicine relative to in-hospital admisssions, hospital stays, outpatient surgeries, and pharmaceutical costs. Patient surveys show a higher rate of satisfaction when compared with those receiving conventional treatments.

Comparison of Health Care Expenditures Among Insured Users and Nonusers of CAM in Washington State: A Cost Minimization Analysis
Bonnie Lind, William Lafferty, Patrick Tyree, Paul Diehr

This study explores claims data and health care expenditures between CAM-using patients and CAM-nonusing patients and found that CAM-using patients had lower inpatient and imaging cost than the comparison group. The patients with the heaviest disease burden had the most reductions in expenditures.

Patients whose GP knows complementary medicine tend to have lower costs and live longer
Peter Kooreman, Erik Baars

This Dutch study compared healthcare costs at the patient level for treatments administered by GPs with CAM training versus GPs without additional CAM training. Findings suggest that patients seen by GPs with additional CAM training had lower pharmaceutical and fewer hospital visits.

The Use of Complementary and Alternative Medical Providers by Insured Cancer Patients in Washington State
William Lafferty, Allen Bellas, Andrea Corage Baden, Patrick Tyree, Leanna Standish, Ruth Patterson

Findings from this study suggest that insured cancer patients will use naturopathy, massage therapy and chiropractic care in conjunction with conventional care. Costs related to the average billed amount per CAM discipline was determined to be quite reasonable.

Comparative analysis of individuals with and without chiropractic coverage: patient characteristics, utilization, and costs
Legorreta AP , Metz RD, Nelson CF, Ray S, Chernicoff HO, Dinubile NA

Four year analysis using claims data revealed that individuals with chiropractic care coverage had lower annual total health care expenditures when compared to those without chiropractic care coverage. Patients with low back pain used fewer imaging services and had less surgical interventions than those without chiropractic coverage.

The effect of acupuncture utilization on healthcare utilization
Bonafede M , Dick A, Noyes K, Klein JD, Brown T

Findings from this study using claims data show that acupuncture can be an economic substitute for some medical services inlcuding primary care, outpatient services, pathology services, surgery, and gastrointestinal and pain medications. Results also suggest that the costs associated with acupuncture may be recuperated through a decline in other types of healthcare utilization.

Cost of Care for Common Back Pain Conditions Initiated with Chiropractic Doctors VS Medical Doctors/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer
Richard Liliedal, Michael Finch, David Axene and Christine Goertz

Retrospective claims analysis using a popultion of Blue Cross Blue Shield insurees focusing on low back pain found that costs were approximately 40% less when care was initiated by chiropractic doctors as compared to medical doctors