Integrating Acupuncture into Primary Care

To investigate the viability of integrating acupuncture services into a Patient-Centered Primary Care Home (PCPCH) and Federally Qualified Healthcare Center (FQHC) located in a frontier community. The study had two primary aims: (1) to assess demographics, clinical characteristics, and utilization patterns of patients who accessed acupuncture services at Winding Waters Community Health Center (WWCHC), (2) to perform cost-benefit analysis using a basic revenue versus expense calculation. This observational study consisted of two primary components: (1) a retrospective chart review and (2) a basic cost versus revenue assessment. WWCHC, an FQHC located in frontier Northeastern Oregon. Data from 551 charts of patients aging ≥18 years who accessed acupuncture services at WWCHC between January 2017 and December 2018. Patients attended 3210 acupuncture visits. The demographics of patients utilizing acupuncture services reflected community demographics. Mean age was 54 years (±16.9) and 99 patients (18%) reported income below the federal poverty level. The prevalent chief complaint was back and neck pain (46.6% of visits). WWCHC medical providers placed 538 internal referrals for patients to receive acupuncture. Although patients are actively utilizing insurance benefits for acupuncture, reimbursement remains a challenge. Reimbursement rates ranged between 34% and 69% of billed rate. In 2018, 779 visits were paid by patients at an average rate of $48.71 per visit. Despite challenges, clinic revenue for acupuncture services exceeded costs by 4%. The acupuncture program at WWCHC is economically feasible and well utilized by patients. Adequate reimbursement remains a challenge, but it is not cost-prohibitive and provides a nonpharmacologic treatment option in this frontier setting. Revenue for acupuncture services exceeded costs by 4%.