Trends in Insurance Coverage for Complementary Health Care Services

Area of Science:

• Health Services Research
• Complementary and Alternative Medicine
• Health Economics

Background:

• Complementary health professionals provide significant clinical services in the U.S.
• Inadequate insurance coverage is a concern for many complementary health services.
• Previous studies indicated a need for longer-term trend analysis.

Purpose of the Study:

• To evaluate trends in health insurance reimbursement for complementary health services over a seven-year period (2011-2017).
• To compare reimbursement rates for acupuncturists, chiropractors, and naturopaths against primary care physicians.

Main Methods:

• Retrospective serial cross-sectional design analyzing health insurance claims in New Hampshire.
• Focused on non-emergent outpatient Current Procedural Terminology code 99213 claims.
• Used generalized estimating equation models to compare reimbursement likelihood, defining reimbursement as payment >0 dollars.

Main Results:

• Reimbursement likelihood for naturopathic physicians was initially higher but decreased from 2014 onwards.
• Acupuncture and chiropractic claims consistently showed lower odds of reimbursement throughout the study.
• In 2017, reimbursement likelihood was 77% lower for acupuncturists, 72% for chiropractors, and 64% for naturopaths compared to primary care.

Conclusions:

• The likelihood of insurance reimbursement for complementary health services is substantially lower than for primary care in New Hampshire.
• This disparity in reimbursement may significantly hinder patient access to essential complementary health treatments.
• Further investigation into insurance coverage policies for complementary medicine is warranted.