Restricted access to chiropractic care in older adults raises medical costs by millions.

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Growing chiropractic use for many spinal conditions is more effective and safer than visiting a medical primary care physician first. Chiropractic has much higher levels of patient satisfaction according to Consumer Reports, Men's Health magazine, and many other publications. The opioid crisis was caused by medical providers treating painful conditions medicinally instead of with chiropractic care or physical therapy. As those patients did not respond, they were then referred to higher-level tests and procedures of questionable benefit, often at a much higher cost. Yesterday, a patient with sciatic pain and a history of lower back problems had the experience of being referred to providers for injections and he had costly MRIs in the absence of lower cost and less risky care from a chiropractor.   He felt a marked reduction of pain during his first visit and finally understood why his lower back was frequently injured. Visiting a chiropractor first would have prevented years of suffering while reducing cost and risk.  He never knew until his sister insisted he visit our offices. Under Medicare, chiropractic coverage has been restricted to manipulation of the spine only since its inception. The most effective providers also include exercises, soft tissue techniques, and perform needed examinations to fully understand their patient's needs. Those patients are paying out of pocket for those uncovered services which are often more effective and of lower risk and cost than what is available in the medical system. Others on fixed incomes often forgo chiropractic care which is made more expensive by Medicare coverage.   These patients are often visiting their primary care physicians who are using medicinal care and therapy, rather than more effective methods such as chiropractic. Medicaid patients are often in the same predicament. A recent study by the JMPT (Journal of Manipulative and Physiological Therapeutics) showed reducing access to chiropractic care is costing the system conservatively $391 Million dollars annually. This was based on 39,278 older adult chiropractic care users who relocated during 2010-2014 and experienced a change of access to chiropractic care. The current reimbursement for chiropractic care must be updated to today's standards, with chiropractors who are primary care for the musculoskeletal care being reimbursed under the full scope of their state license. Who you visit first can determine the cost, risk, and effectiveness of their care. Insurers are partly to blame for making rehabilitative care more expensive than it should be through tiered plans, high deductibles, and high copayments.  Massive consolidation of hospitals and doctors' offices also contributes because hospital-owned physician practices are incentivized to feed the higher cost hospital-based facilities and providers, regardless of effectiveness. The American Chiropractic Association has been collecting more sponsors for the Chiropractic Modernization Act H.R. 2654.   You can help this happen by contacting your congressperson and senators.  The time to act is now. Use this link to show your support.