Ten modifiable health risk factors are linked to more than one-fifth of employer-employee health care spending.

An underlying premise of the Affordable Care Act provisions that encourage employers to adopt health promotion programs is an association between workers' modifiable health risks and increased health care costs. Employers, consultants, and vendors have cited risk-cost estimates developed in the 1990s and wondered whether they still hold true. Examining ten of these common health risk factors in a working population, we found that similar relationships between such risks and total medical costs documented in a widely cited study published in 1998 still hold.

Chiropractic in North America: toward a strategic plan for professional renewal--outcomes from the 2006 Chiropractic Strategic Planning Conference.

Objective: This report describes the process, participation, and recommendations of a set of consensus conferences on strategy for professional growth that emphasized elements of public trust and alignment between the chiropractic profession and its stakeholders.

Methods: In February and August 2006, an invitational group of leaders in the chiropractic profession convened an ad hoc Chiropractic Strategic Planning Conference. Public notice was given and support solicited through the Foundation of Chiropractic Education and Research.

Health and medical economics applied to integrative medicine.

Cost-benefit analyses (CBA) of every aspect of health and medical care are a necessity to address both the clinical effectiveness and cost effectiveness of health and medical care for the purpose of allocating limited practitioner, organizational, governmental, and monetary resources while maintaining the highest quality outcomes. In response, there are an array of approaches that emphasize the full continuum of prevention, restructuring primary care, involvement of the workplace and communities, and adoption of innovative strategies and interventions ranging from genomic assessments to complementary and alternative medicine (CAM). Among these approaches is an integrative medicine (IM) model that is consistent with these national objectives and that uniquely and explicitly includes "evidence-based global medical strategies" in its definition.

Using a return-on-investment estimation model to evaluate outcomes from an obesity management worksite health promotion program.

Objective: Certain modifiable risk factors lead to higher health care costs and reduced worker productivity. A predictive return-on-investment (ROI) model was applied to an obesity management intervention to demonstrate the use of econometric modeling in establishing financial justification for worksite health promotion.

Methods: Self-reported risk factors (n = 890) were analyzed using chi2 and t test methods.

How can chiropractic become a respected mainstream profession? The example of podiatry.

Background: The chiropractic profession has succeeded to remain in existence for over 110 years despite the fact that many other professions which had their start at around the same time as chiropractic have disappeared. Despite chiropractic's longevity, the profession has not succeeded in establishing cultural authority and respect within mainstream society, and its market share is dwindling. In the meantime, the podiatric medical profession, during approximately the same time period, has been far more successful in developing itself into a respected profession that is well integrated into mainstream health care and society.

A diagnosis-based clinical decision rule for spinal pain part 2: review of the literature.

Background: Spinal pain is a common and often disabling problem. The research on various treatments for spinal pain has, for the most part, suggested that while several interventions have demonstrated mild to moderate short-term benefit, no single treatment has a major impact on either pain or disability. There is great need for more accurate diagnosis in patients with spinal pain.

Effects of a managed chiropractic benefit on the use of specific diagnostic and therapeutic procedures in the treatment of low back and neck pain.

Objective: The aim of this study was to measure the effects of a managed chiropractic benefit on the rates of specific diagnostic and therapeutic procedures for the treatment of back pain and neck pain.

Design: This study is a retrospective analysis of claims data from a managed-care health plan over a 4-year period. The use rates of advanced imaging, surgery, inpatient care, and plain-film radiographs were compared between employer groups with and without a chiropractic benefit.

Chiropractic as spine care: a model for the profession.

Background: More than 100 years after its inception the chiropractic profession has failed to define itself in a way that is understandable, credible and scientifically coherent. This failure has prevented the profession from establishing its cultural authority over any specific domain of health care.

Objective: To present a model for the chiropractic profession to establish cultural authority and increase market share of the public seeking chiropractic care.

The selection effects of the inclusion of a chiropractic benefit on the patient population of a managed health care organization.

Objective: The aim of this study is to measure the selection effects of the inclusion of a chiropractic benefit on a managed care health plan.

Design: An analysis of enrollment data from a managed care health plan over a 4-year period was conducted. Employers could select the managed care plan with or without a chiropractic care benefit.

Comparative analysis of individuals with and without chiropractic coverage: patient characteristics, utilization, and costs.

Background: Back pain accounts for more than $100 billion in annual US health care costs and is the second leading cause of physician visits and hospitalizations. This study ascertains the effect of systematic access to chiropractic care on the overall and neuromusculoskeletal-specific consumption of health care resources within a large managed-care system.

Methods: A 4-year retrospective claims data analysis comparing more than 700 000 health plan members with an additional chiropractic coverage benefit and 1 million members of the same health plan without the chiropractic benefit.

Chiropractic care: is it substitution care or add-on care in corporate medical plans?

An analysis of claims data from a managed care health plan was performed to evaluate whether patients use chiropractic care as a substitution for medical care or in addition to medical care. Rates of neuromusculoskeletal complaints in 9e diagnostic categories were compared between groups with and without chiropractic coverage. For the 4-year study period, there were 3,129,752 insured member years in the groups with chiropractic coverage and 5,197,686 insured member years in the groups without chiropractic coverage.