In 2018, we as a nation spent $3.6 trillion on healthcare expenses according to data reported by the Centers for Medicare & Medicaid Services (CMS). This includes monies spent on private health insurance, Medicare, and Medicaid, as well as out of pocket spending, prescription drug spending, and expenditures related to hospital stays, physician, and clinical services.

The CMS further states that these costs are expected to grow by 5.5 percent per year, almost doubling by the year 2027, when they are anticipated to reach almost $6 trillion. New research shows that one way to potentially drive down these costs is by allowing our top healthcare systems to cover chiropractic care services.

Chiropractic and Reduced Healthcare Costs

In December 2019, the Journal of Chiropractic Humanities published a study designed to assess whether Medicaid costs in the state of Missouri could be lowered by providing recipients chiropractic care benefits. This is important since the decision to provide chiropractic coverage is ultimately determined by the benefits it provides versus its cost.

In this study, the authors used a dynamic scoring approach to determine the true cost of adding doctors of chiropractic (DCs) under Missouri Medicaid. This varies from the static scoring method that had been previously used before.

Dynamic vs Static Scoring

Authors state that the difference between dynamic scoring—which is the method of scoring required by Congress since 2015—and static scoring is that “dynamic scoring considers the changes in human behavior that result from legislative change while static scoring does not.”

For instance, if a law was passed that your pay was to be cut by $5 per hour, static scoring would only look at the impact this would have on the federal, state, and local budgets. Dynamic scoring, on the other hand, would also look at how your behaviors would potentially change due to this new law. Changes that would likely include going out to eat less, reducing your household expenses, and maybe even choosing a lesser insurance plan to help offset the loss.

True Savings of Chiropractic Care

This study found a number of errors and shortcomings with dynamic scoring which were misleading the state, making it harder for its healthcare leaders to see the value that chiropractic has to offer from a cost perspective. Costs that revealed that if chiropractic was covered, it could save the Medicaid system as much as $49.2 million per year.

These savings can be broken down into three categories:

  • Chiropractic providing better treatment outcomes at a lower cost;
  • Chiropractic reducing costs associated with spinal surgery; and
  • Chiropractic reducing costs from opioid prescription use and abuse.


Thus, chiropractic offers three very distinct cost-saving benefits, helping to reduce our nation’s total healthcare costs.

McGowan JR, Suiter L. Cost-Efficiency and Effectiveness of Including Doctors of Chiropractic to Offer Treatment Under Medicaid: A Critical Appraisal of Missouri Inclusion of Chiropractic Under Missouri Medicaid. Journal of Chiropractic Humanities. 2019 Dec 10;26:31-52. doi: 10.1016/j.echu.2019.08.004. eCollection 2019 Dec. Review. PubMed PMID: 31871437; PubMed Central PMCID: PMC6911936.

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