On-site Chiropractic Lowers Employee Medical Costs

Offering chiropractic care at on-site health facilities could decrease employee medical costs associated with musculoskeletal injuries and headache, suggests the results of a recent study.

Musculoskeletal injuries are the most common cause of worker disability in the US, resulting in significant clinical and economic burden. Every year, Americans spend between $84-624.8 billion on treating back pain alone. Efforts to increase access to effective treatments could reduce health-care costs while improving productivity.

Employee Health-care Utilization Study

Executives at Cerner Corporation, a health IT company, were recently interested in seeing whether chiropractic care could reduce health-care utilization in their employees. (Lower health-care utilization means less visits to the doctor and fewer expensive tests or procedures). They hired a team of researchers to conduct an analysis of employee health records in workers who received chiropractic care for back pain, neck pain, and headache. The analysis included 309 associates treated at an on-site company health facility and 858 associates treated at off-site community clinics.

Employees treated by a chiropractor, whether on-site or off-site, had significantly reduced disability scores on tests that evaluated headache, neck pain, and back pain. On average, chiropractic patients had 19% reduction in headache disability scores, a 14.6% reduction in neck pain disability scores, and a 14.5% reduction in back pain disability scores.

Although off-site chiropractic patients were just as likely to have reduced pain, the employees who received on-site care had fewer doctor's visits and reduced health-care utilization. Employees treated off-site were more likely to have outpatient visits, although the average number of outpatient visits were similar in both groups.

In one year of treatment in employees who received off-site care, the average physical therapy patient had 13.6 visits compared to 8.9 visits for chiropractic patients, and 23 visits for physician patients. (The physician's visits could have been elevated due to the fact that the data included visits non-related to musculoskeletal conditions). For those treated with on-site care, the average patient was less likely to receive physical therapy and more likely to be treated by chiropractor.

Impact on Employee Health-care Costs

The researchers concluded that on-site chiropractic care reduced health-care utilization while improving employee functional status related to musculoskeletal condition. They suggested that on-site facilities offer more opportunities for coordination and integration among different health services.

"The improved functional status indicates potential for reduced indirect costs, including absenteeism, presenteeism and productivity losses, with on-site chiropractic services," Kat Gorman, MPH, research scientist with Cerner Corporation wrote with colleagues in the executive summary of the study. "Additionally, direct cost savings may result through lower rates of health-care utilization." Gorman and her colleagues concluded that more research is needed to assess the potential for indirect and direct cost savings of on-site chiropractic care.

Earlier research has suggested that chiropractic patients have lower medical costs compared to patients under a physician's care for back pain, and a recent study found that chiropractic patients missed fewer work days.


Krause CA, et al. Value of chiropractic services at an off-site health center. Journal of Occupational and Environmental Medicine 2012; 54(8):917-21. doi: 10.1097/JOM.0b013e31825a3507.

Dagenais S, et al. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine Journal 2008; 8 (1): 8-20.