Insurance Companies' Fears of Covering Acupuncture Appear Unfounded

Acupuncture is one of the oldest and most commonly used forms of traditional medicine in the world. A 1997 National Institutes of Health Consensus Statement supported the beneficial effects of acupuncture for a range of conditions. In recent years, utilization, spending, and research related to acupuncture have increased significantly. Despite these trends, little is known about the use of acupuncture in relation to conventional medical services.

RAND Health researcher Andrew Dick was part of a team that sought to determine if individuals use acupuncture as a substitute for or as a complement to other medical services. For their analyses, the team employed statistical models to examine medical and drug claims data for 17,970 people, including 1,688 acupuncture users, from a midsize metropolitan insurance company.

The study found that acupuncture use does affect the utilization of other medical services and pharmaceuticals. Specifically,

• Acupuncture substituted for primary care, all outpatient services, pathology services, all surgery, and gastrointestinal medications. These relationships were documented at statistically significant levels.
• Acupuncture seemed to complement some therapies, particularly chiropractic and physical therapy and allergy services.

The researchers suggest that expenditures on acupuncture may be offset through reductions in other health care utilization, countering insurance companies' fears that covering acupuncture will raise costs. If acupuncture is being used largely in place of more expensive conventional medical services, then it has the potential to reduce total medical expenditures. However, additional studies are needed to clarify this picture, including

• analyses with larger data sets (involving more acupuncture users) to determine whether acupuncture truly has no effect on utilization of those medical services that, in the current study, showed no statistically significant relationships with acupuncture use
• an examination of how substituting acupuncture for conventional medical services, especially preventive services, such as cancer screening, affects patient health
• evaluation of expenditure data to quantify the financial impact of acupuncture.