Beginning next year, the Oregon Health Plan (OHP) will prioritize chiropractic and other complementary therapies over painkillers or surgery for patients with back pain. It’s a huge shift from the previous policy, which heavily favored narcotics as the first line of defense against pain.
For many patients, painkillers were the only option. Of the 8 percent of OHP patients who sought back pain treatment in 2013, only a narrow sliver met the plan’s requirements for chiropractic care, while more than half received narcotics.
“There should be an array of things for people to choose from, whether it be chiropractic care, naturopathic care, acupuncture, nutrition or massage,” said Dr. Dave Eisen, executive director of The Quest Center for Integrative Health in Portland. “If they don’t work, you use opioids … as a last resort,” he said.
Under the new policy, OHP patients will be able to receive chiropractic treatment—as well as acupuncture, cognitive behavioral therapy, osteopathic manipulation, and physical and occupational therapy—up to 30 times a year.
Why chiropractic care trumps painkillers
The changes to the Oregon Health Plan represent a step in the right direction. Using narcotics as a long-term treatment for chronic pain opens the door to addiction, and health care providers estimate as many as a quarter of patients on long-term opioid treatment end up abusing the drugs.
In fact, officials believe using painkillers as the go-to treatment for back pain may have contributed to Oregon’s status as the nation’s leader in opioid abuse. More than 900,000 Oregonians received opioid prescriptions in 2012.
Addiction risks aside, chiropractic care simply works better. While painkillers merely mask the symptoms without addressing the underlying problem, chiropractic treatment aims to heal the imbalance that’s causing the chronic pain.
There’s plenty of research to back up the Oregon Health Plan’s decision. A 2003 study found that spinal manipulation offers greater short-term back pain relief than a variety of medications, and in 2004 researchers found chiropractic care more effective than medical care at treating chronic lower back pain.
What this means for Oregon chiropractors
Chiropractors in Oregon can expect to see an influx of OHP patients seeking treatment for ongoing back problems.
“The number of people who qualify under the guidelines for treatment is pretty narrow, and they’re expanding it dramatically, so I think it would certainly almost double,” said Dr. Alison Little of PacificSource Community Solutions, which administers OHP for Central Oregon.
Additionally, chiropractic care providers who have had billing problems with OHP in the past may find the reimbursement rate improved once the new policy kicks in Jan. 1, 2016.
While chiropractic care and other therapies may cost the health plan more in the short term, officials hope it will pay off by resulting in fewer surgeries and a decline in narcotics use, said Denise Taray of the Oregon Pain Management Commission.
“Research is out there that suggests that with back conditions we’re spending a lot of money on health care treatment and services that aren’t improving outcomes,” she said. Fortunately, chiropractic treatment has an excellent track record in that department.