Worker's Comp in California Cuts Down Chiro Visits

A study examining a robust claims processing system in CA, complemented by mandatory utilization review and caps on chiropractic visits at 24 (perhaps a moving target) seems to be working wonders in cutting down the cost of health care._
http://www.cwci.org/icis/ViewReport.CFM?&ReportIndex=21_
(http://www.cwci.org/icis/ViewReport.CFM?&ReportIndex=21)
"The average number of chiropractic manipulations recorded 9 months after injury declined from 28.5 to 12.6 visits, a 55.8 percent reduction, while the average amount paid per claim for chiropractic manipulation at 9 months fell by 60.9 percent."

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This CA Workers Compensation report also showed correlative reductions in Physical Therapy treatments. Chiropractic manipulation does not seem to be a key focus of the study, or the report. Here's an important note published with the study:
"These results represent a “first-look” at physicaltherapy and chiropractic manipulation utilization andcosts following implementation of the 2003[Utilization Management] reforms. Availability of data only through 2004 limits the ability to observe longer term results. As we know, ultimate medical costs take years to develop and prior reform efforts have shown promising early returns only to be neutralized bycourt decisions, policy reversals or medical marketforces..."

Outside pharm therapy, insurers are skeptical of therapy that appears to go on forever. But it all comes down to what we expect and demand that insurance cover. Do we obligate payors to provide coverage so long as the treatment continues to provide some benefit, even if it's only to prevent regression, increase strength, or to reduce risk of reinjury? Or, do we limit it as soon as functional ability is restored? Are the UM reforms in the study depriving patients of medically necessary care, or are they eliminating health fraud?

Politics will have muchmore to say than science in this, I bet.

nawledge