Acupuncture use is increasing, but many insurers do not cover it
Even though the number of patients who visited an acupuncturist about doubled from 2010 to 2019, and insurance coverage for the treatment increased, most patients continued to pay out of pocket, according to recent data.
“Any decrease in opioid prescribing [for chronic pain] is a welcome public health trend,” Molly Candon, PhD, an assistant professor in the department of health care management in the Wharton School, director of the associate fellows program in the Leonard Davis Institute of Health Economics, and research assistant professor of psychiatry in the Perelman School of Medicine at the University of Pennsylvania, told Healio. “Still, opioid overdoses and deaths continue to increase. The fact remains that chronic pain affects over one in five adults in the U.S. and is very expensive to treat. Our results suggest that inadequate insurance coverage may serve as a barrier to safe, effective and cost-effective pain care.”
In a research letter published in JAMA Network Open, Candon and colleagues examined insurance coverage for acupuncture visits between 2010 and 2019 using data from the Medical Expenditure Panel Survey. Adults who responded to the survey reported acupuncture use and demographic information. The researchers’ analysis focused solely on respondents who reported at least one acupuncturist visit during the study period.
Occurrence of acupuncturist visits
The proportion of respondents who reported an acupuncturist visit increased from 0.4% in 2010 to 0.8% in 2019, according to Candon and colleagues. Of the 1,344 acupuncture users, 68.6% were women and the mean age was 51.9 years. Also, 57.1% of the users were white, 18.7% were Asian, 15% were Hispanic and 6.3% were Black.
Costs associated with acupuncturist visits
The total annual amount paid for acupuncturist visits increased from a mean of $593 (95% CI, 460.29-725.7) in 2010 to 2011 to $1,021.57 (95% CI, 806.32-$1,236.82) in 2018 to 2019. Annual out-of-pocket costs also increased, from a mean of $375.51 (95% CI, 286.12-464.9) to $554.26 (95% CI, 383.54-724.99). However, the increase was not statistically significant, according to the researchers. The increase in out-of-pocket costs was largely attributable to an increase in acupuncturist visits among users, from a mean of 5.4 visits (95% CI, 4.2-6.6) per person in 2010 to 8.2 visits (95% CI, 6.4-9.9) per person in 2019.
The share of acupuncturist visits with any insurance coverage increased by an average of 9.1 percentage points (95% CI, 5.6-12.7), from a mean of 41.1% (95% CI, 38.1-44) in 2010 to 2011 to 50.2% (95% CI, 48.3-52.1) in 2018 to 2019. Meanwhile, Candon and colleagues observed that the percentage of costs paid by respondents out of pocket, with or without insurance, decreased by an average of 9.4 percentage points (95% CI, 12.5 to 6.3) from a mean of 66.9% (95% CI, 64.4-69.3) in 2010 to 2011 to 57.5% (95% CI, 55.8-59.1) in 2018 to 2019.
Despite an increase in insurance coverage for acupuncturist visits, the researchers noted that about half of respondents reported no insurance coverage, and most spending was paid out of pocket.
“The more that acupuncture is covered by insurance, the more viable it will become for chronic pain patients,” Candon said. “It’s worth noting that the cost for an individual acupuncture session was between $100 and $125 in most years. This amount is similar to (or even cheaper than) the cost of other interventions such as physical therapy.”
Acupuncture as a form of pain care is recommended by several governing bodies, including the U.S. Agency for Healthcare Research and Quality, FDA, NIH and the Joint Commission, “which begs the question of why insurers don’t cover it more,” she added.