Chiropractors, physical therapists laud JFC action to develop Medicaid pilot program

Organizations representing Wisconsin chiropractors and physical therapists back a budget provision approved by the Legislature’s Joint Finance Committee that would require the state’s health department to develop a pilot program promoting the use of chiropractic care as well as physical and occupational therapy to treat pain.

The provision, approved by the committee last week, directs the Department of Health Services to study the impact of chiropractic and physical therapy on the use of prescription and over-the-counter drugs.

If the provision makes it into law, DHS would submit a report to the Legislature next year that includes the framework for a pilot project encouraging Medicaid patients to use chiropractic and physical therapy instead of drugs. The department wouldn’t be able to implement the program unless directed by the Legislature.

Connie Kittleson, Wisconsin Physical Therapy Association president, said there are alternatives to opioids for pain control, like physical therapy and chiropractic care.

“We’re hoping that the pilot could show that using some non-pharmacological treatments can help people not use opioids to the extent that they are now,” she said. “We’re just looking forward to being able to work with physicians to help their patients.”

Kittleson added that narcotics have “their time and their place” but physical therapy can be an additional tool that physicians can use to help their patients.

“By looking at what works, we can better formulate a pilot program that would show how Wisconsin Medicaid patients can more effectively utilize chiropractic care,” John Murray, Wisconsin Chiropractic Association executive director, said in a statement.

Some states have pilot programs encouraging the use of complementary and alternative medicine services, like chiropractic care, for chronic pain.

A three-year pilot program in Florida that targeted three counties reduced per member per costs and led to satisfied patients, according to an evaluation of the program. Lawmakers extended the pilot for an additional three years, but researchers found it didn’t lead to cost savings during the extension and recommended its discontinuation, according to an August 2016 brief from the National Academy for State Health Policy.

Oregon and Rhode Island also have pain management programs that include chiropractic care and other alternatives to opioids, the brief noted. But the authors wrote that other states have been hesitant to establish such programs due to a lack of evidence around quality outcomes and cost-effectiveness as well as state budget constraints.

Steve Conway, Chiropractic Society of Wisconsin executive director, said that the proposed pilot project and study could benefit other patients as the information gathered by DHS can “be extrapolated out to the entire population.”

“There’s a lot of patients that have pain,” he said. “There’s natural healthcare methods like chiropractic or physical therapy that people can actually start out with first before they have to resort to trying opioids.”