Research Article Archive

Implementation of the Primary Spine Care Model in a Multi-Clinician Primary Care Setting: An Observational Cohort Study.

SCU Health Researchers

Jim Whedon, Toler A, Bezdjian S, Goehl J, Russell R, Kazal L, Nagare M.

Overview

Complementary health care professionals deliver a substantial component of clinical services in the United States, but insurance coverage for many such services may be inadequate. The objective of this project was to follow up on an earlier single-year study with an evaluation of trends in reimbursement for complementary health care services over a 7-year period.

Trends in the use and cost of chiropractic spinal manipulation under Medicare Part B

SCU Health Researcher

Jim Whedon

Overview

Concern about improper payments to chiropractic physicians prompted the US Department of Health and Human Services to describe chiropractic services as a ‘‘significant vulnerability’’ for Medicare, but little is known about trends in the use and cost of chiropractic spinal manipulation provided under Medicare.

Use of Chiropractic Spinal Manipulation in Older Adults Is Strongly Correlated With Supply

SCU Health Researcher

Jim Whedon

Overview

To examine the relationship between regional chiro- practic supply and both use and utilization intensity of chiropractic services among Medicare beneficiaries.

Relevance of Quality Measurement to Integrative Healthcare in the United States

SCU Health Researcher

Jim Whedon

Overview

With the advent of new models for payment and delivery of healthcare services, the use of quality measures for continual improvement of clinical healthcare is now an integral feature of medical practice in the United States. However, quality measurement and quality improvement activities are not common practice among integrative health providers. This article discusses the import and application of quality measurement to the practice of integrative healthcare. It reviews developments in the healthcare quality improvement movement, explores the relevance of quality measures to integrative healthcare, describes examples of the current use of quality measures in integrative health practice, discusses discriminatory policies that may prevent participation in quality improvement by integrative health practitioners, and makes recommendations for practice and policy.

Beyond spinal manipulation: should Medicare expand coverage for chiropractic services? A review and commentary on the challenges for policy makers

SCU Health Researcher

Jim Whedon

Overview

Private insurance plans typically reimburse doctors of chiropractic for a range of clinical services, but Medicare reimbursements are restricted to spinal manipulation procedures. Medicare pays for evaluations performed by medical and osteopathic physicians, nurse practitioners, physician assistants, podiatrists, physical therapists, and occupational therapists; however, it does not reimburse the same services provided by chiropractic physicians. Advocates for expanded coverage of chiropractic services under Medicare cite clinical effectiveness and patient satisfaction, whereas critics point to unnecessary services, inadequate clinical documentation, and projected cost increases. To further inform this debate, the purpose of this commentary is to address the following questions: (1) What are the barriers to expand coverage for chiropractic services? (2) What could potentially be done to address these issues? (3) Is there a rationale for Centers for Medicare and Medicaid Services to expand coverage for chiropractic services?

Association Between Utilization of Chiropractic Services for Treatment of Low-Back Pain and Use of Prescription Opioids

SCU Health Researcher

Jim Whedon

Overview

Pain relief resulting from services delivered by doctors of chiropractic may allow patients to use lower or less frequent doses of opioids, leading to reduced risk of adverse effects. The objective of this investigation was to evaluate the association between utilization of chiropractic services and the use of prescription opioid medications.

Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain

SCU Health Researcher

Jim Whedon

Overview

Utilization of nonpharmacological pain management may prevent unnecessary use of opioids. Our objec- tive was to evaluate the impact of chiropractic utilization upon use of prescription opioids among patients with spi- nal pain.

Insurance Reimbursement for Complementary Healthcare Services

SCU Health Researcher

Jim Whedon

Overview

Insurance reimbursement for clinical services provided by complementary healthcare profes- sionals in the United States likely differs by provider specialty. It is hypothesized that a lower likelihood of insurance reimbursement demonstrates that complementary healthcare services are not utilized to an optimal level and are not financially accessible to all who may need or want these services. The purpose of this project was to evaluate the likelihood of insurance reimbursement for complementary healthcare services compared with other complementary services and with conventional primary care medical services in New Hampshire.

Challenges of Withdrawal From Chronic Antidepressant Medication: A Healing Odyssey

SCU Health Researcher

Jim Whedon

Racial Disparities in Use of Chiropractic Services by Medicare Beneficiaries Aged 65 to 99 in Los Angeles County, California

SCU Health Researcher

Jim Whedon

Overview

Racial and ethnic disparities in utilization of chiropractic services have been described at the state level, but little is known about such local disparities. We analyzed Medicare data for the year 2008 to evaluate by ZIP code for utilization of chiropractic services among older adults in Los Angeles County, California. We evaluated for availability and use of chiropractic services by racial/ethnic category, quantified geographic variations by coefficient of variation, and mapped utilization by selected racial/ethnic categories. Among 7502 beneficiaries who used chiropractic services, 72% were white, 12% Asian, 1% black, 1% Hispanic, and 14% other/unknown. Variation in the number of beneficiaries per ZIP code who used chiropractic services was highest among Hispanics, blacks, and Asians. We found evidence of racial disparities in use of chiropractic services at the local level in Los Angeles County. Older blacks and Hispanics in Los Angeles County may be underserved with regard to chiropractic care.

Association Between Utilization of Chiropractic Services for Treatment of Low Back Pain and Risk of Adverse Drug Events

SCU Health Researcher

Jim Whedon

Overview

Mortality rates due to adverse drug events (ADEs) are escalating in the United States. Analgesics are among the drug classes most often associated with occurrence of an ADE. Utilization of nonpharmacologic chiropractic services for treatment of low back pain could lead to reduced risk of an ADE. The objective of this investigation was to evaluate the association between utilization of chiropractic services and likelihood of an ADE.

Bioidentical Estrogen for Menopausal Depressive Symptoms: A Systematic Review and Meta-Analysis

SCU Health Researcher

Jim Whedon

Overview

Deaths from injuries related to certain prescription medications, or adverse drug events (ADEs), are rising in the United States. Analgesics are one of the drug classes most often associated with an ADE. Treating low back pain with nonpharmacologic chiropractic services could lead to reduced risk of an ADE. This study observed the association between utilization of chiropractic services and likelihood of an ADE.