Insurance Coverage Affects CAM Usage

Research in Washington State reveals that a substantial number of people use CAM (complementary and alternative medicine) insurance benefits. Since 1996 the state has mandated private insurance companies to cover the services of CAM providers. According to researchers, this law “creates a window through which consumer behavior under various CAM and conventional benefit structures can be monitored and the effect on healthcare can be measured.”

The 2002 study, “Insurance Coverage and Subsequent Utilization of Complementary an Alternative Medicine Providers,” evaluated the use of CAM by more than 600,000 insurance enrollees. Results of the study were published in the July 2006 issue of The American Journal of Managed Care (www.ajmc.com). Among these enrollees, 13.7 percent made CAM claims, including 1.3 percent for acupuncture, 1.6 percent for naturopathy, 2.4 percent for massage, and 10.9 percent for chiropractic.

In addition, the study revealed that people insured by preferred provider organizations (PPOs) and point-of-service products (POS) were notably more likely to use CAM than those with HMO coverage. The most frequent users were in the 31–50 age range, and women used CAM more than men did.

Musculoskeletal pain was the most common diagnosis from a CAM visit (accounting for 92.7 percent of visits to massage therapists), and the median per-visit expenditure was $39. The authors concluded that although the number of people using CAM insurance benefits was substantial, the effect on insurance expenditures was modest.