Despite delivering high-value care that consistently outperforms many traditional pathways for musculoskeletal conditions, chiropractic and physical therapy remain marginalized in medical networks, payer contracts, and referral streams. One might assume this is due to a lack of research—but that’s not quite the case.

Neck and back pain are among the most common reasons for healthcare utilization in the United States. Care pathways for these conditions vary substantially depending on the type of provider initially contacted. This variability affects service utilization, total episode costs, care duration, number of providers seen, and outcomes. Arete Network analyzed national data from a commercially insured population with an uninterrupted 3-year coverage period to characterize these pathways.

PPO networks are influencing how chiropractic and physical therapy providers practice and organize. The impact on both provider and consumer is significant.