BACKGROUND CONTEXT:

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.

PURPOSE:

To quantify the volume and cost of chiropractic spinal manipulation services for older adults under Medicare Part B and identify longitudinal trends.

STUDY DESIGN/SETTING:

Serial cross-sectional design for retrospective analysis of administrative data.

PATIENT SAMPLE:

Annualized nationally representative samples of 5.0 to 5.4 million beneficiaries.

OUTCOME MEASURES:

Chiropractic users, allowed services, allowed charges, and payments.

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