About 47% of employees with health plans had acupuncture coverage in 2004, the Wall Street Journal recently reported from published results of a 3,000-employer survey; while chiropractic coverage increased from 79% of workers with health benefits in 2003 to 87% in 2004.
The Journal, however, in “Health Plans Embrace Alternatives: Acupuncture, Chiropractic Often Can Save Money, Enhance Employee Options,” observed that: “Even as they become more popular, benefits for alternative medicine often remain limited.” For example, chiropractic coverage offered through one insurer was limited to outpatient rehabilitation for a circumscribed number of visits or spending; while the same insurer limited acupuncture coverage to patients with postoperative dental pain or nausea and vomitting from chemotherapy or from pregnancy.
Limiting visits or conditions for which an alternative or complementary therapy is offered is just one way that insurers can market themselves as covering holistic or integrative care, while in fact offering little that is new, and staying close to typical insurance coverage for conventional medical care. Other high-marketing/low-commitment strategies by insurance companies that appear to embrace complementary medicine but may be less significant than marketing hoopla may indicate, include: limiting therapies overall to those that are “medically necessary;” considering complementary therapies in the catch-all exclusion of “experimental therapies;” or merely offering discounts to selected providers, rather than coverage benefits. (See Can I Get My Use of CAM Therapies Reimbursed?) Insurance policies also are “invariably murky,” as noted before, so it’s a good idea to read the policy carefully and get questions answered in writing.
The Journal article did suggest that the increase in insurance coverage for acupuncture and chiropratic represents “a trend … in which alternative medicine has gone more mainstream,” with employers seeing employee insurance benefits for alternative and complementary medicine as potentially reducing overall healthcare insurance coverage costs. But the question as to whether use of these therapies in fact is cost-effective compared to conventional therapies remains to be researched. And results of studies of cost-effectiveness will help drive utilization, as well as reimbursement, institutional acceptance among hospitals and academic medical centers, and health care regulatory policy.
In short, while the increase in insurance coverage for acupuncture and chiropractic represents some movement toward a more level playing field in the health care insurance market, the trend is still a long way from notions of “integrative medicine” that explicitly account for whole-being health.