Related Experiment Video
Updated: Mar 6, 2026
06:03
Operational and Intervention Effects of Targeted Tuina in Lumbar Intervertebral Disc Degeneration Model Rabbits
Published on: July 21, 2023
1.0K
Insurance Reimbursement for Complementary Healthcare Services
James Whedon1, Tor D Tosteson2, Anupama Kizhakkeveettil3
11 Health Services Research, University Health System, Southern California University of Health Sciences , Whittier, CA.
Summary
Insurance reimbursement for complementary healthcare services like acupuncture and chiropractic care is significantly lower than for primary care physicians. This disparity impacts accessibility and optimal utilization of these valuable health services.
Area of Science:
- Health Services Research
- Complementary and Alternative Medicine
- Health Economics
Background:
- Insurance reimbursement for complementary healthcare professionals varies by specialty in the US.
- Lower reimbursement rates may indicate underutilization and financial barriers to accessing these services.
- This study evaluates reimbursement likelihood for complementary services versus conventional primary care in New Hampshire.
Purpose of the Study:
- To compare insurance reimbursement rates for complementary healthcare services with those of conventional primary care.
- To identify disparities in reimbursement based on provider specialty.
- To assess the financial accessibility of complementary healthcare.
Main Methods:
- Analysis of nonemergent outpatient health claims in New Hampshire from 2014.
- Study population: New Hampshire residents aged 18-99 with claims for selected complementary services.
- Comparison of reimbursement proportions for complementary providers versus primary care physicians, including evaluation and management (E&M) services and CPT code 99213.
Main Results:
- Acupuncturists had a 69% lower likelihood of reimbursement for any service compared to PCPs.
- Doctors of chiropractic medicine showed a 71% lower reimbursement likelihood for any service.
- Doctors of naturopathic medicine had a 62% lower reimbursement likelihood for any service compared to PCPs.
Conclusions:
- Significant differences exist in health insurance reimbursement likelihood based on provider specialty in New Hampshire.
- Further research is needed to understand the causes and impact of these reimbursement disparities.
- Reimbursement differences may affect the utilization of complementary healthcare services in the US.
Keywords:
complementary healthcarehealth disparitieshealth insurancehealth policyintegrative healthcareMore Related Videos
Related Concept Videos
01:11Secondary Healthcare System
2.1K
Secondary healthcare is offered by a specialist, generally in hospitals or clinics for patients referred by primary healthcare providers. It occurs when a person has an illness or injury that requires specific medical care. Secondary care is often referred to as acute care. Secondary care can range from uncomplicated care to repair a minor laceration or treat a strep throat infection to more complicated emergent care, such as treating a head injury sustained in an automobile accident. Whatever...
2.1K
01:19Restorative Care
2.4K
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
2.4K
01:30Health Information Technology and Healthcare Information System
3.5K
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
3.5K
01:26Methods Of Healthcare Delivery System
4.2K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
4.2K
01:20Integrated Healthcare System
2.5K
An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...
2.5K
01:21Interdisciplinary Care: The Health Care Team-I
2.8K
An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care.
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
2.8K