Positive Health Online

Abstract

LAFFERTY and co-workers, Department of Health Services, School of Public Health and Community Medicine, University of Washington, Box 357660, Seattle, WA 98195, USA, have investigated how people with health insurance use complementary and alternative medicine.

Background

Since 1996, Washington State law has required that private health insurance cover licensed complementary and alternative medicine providers. The aim of this study was to evaluate how insured people used CAM providers and what role this played in healthcare utilization and expenditures.

Methodology

In this cross-sectional analysis of insurance enrollees from western Washington in 2002, insurance demographic data, claims files, benefit information, diagnoses, CAM and conventional provider utilization, and healthcare expenditures for 3 large health insurance companies were analyzed.

Results

Among more than 600,000 enrolees, 13.7% made CAM claims. This included 1.3% of enrolees with claims for Acupuncture, 1.6% for Naturopathy, 2.4% for Massage, and 10.9% for Chiropractic. Patients enrolled in preferred provider organizations and point-of-service products were notably more likely to use CAM than those with health maintenance coverage. The use of CAM was greater among women and among persons 31 to 50 years of age. The use of Chiropractic was more frequent in less populous counties. The CAM provider visits usually focused on musculoskeletal complaints except for Naturopathic Physicians, who treated a broader array of problems. The median per-visit expenditures were 39.00 dollars for CAM care and 74.40 dollars for conventional outpatient care. The total expenditures per enrolee were 2589 dollars, of which 75 dollars(2.9%) was spent on CAM.

Conclusion

The number of people using CAM insurance benefits was substantial; the effect on insurance expenditures was modest.

References

Lafferty WE, Tyree PT, Bellas AS, Watts CA, Lind BK, Sherman KJ, Cherkin DC, Grembowski DE. Insurance coverage and subsequent utilization of complementary and alternative medicine providers. American Journal of Managed Care 12 (7): 397-404, Jul 2006.