William E. Lafferty, MD¹, Patrick T. Tyree, AA¹, Allen S. Bellas, PhD², and Cindy A. Watts, PhD¹. (1) Department of Health Services, University of Washington, Box 357660, Seattle, WA 98195, 206-616-5085, billlaf@u.washington.edu, (2) Evans School of Public Affaris, University of Washington, Box 353055, Seattle, WA 98195

Objectives: The cost U.S. of medical care increased to over $1.5 trillion dollars in 2002. This study evaluated whether integrating coverage for CAM’s services into conventional health insurance adds substantially to health care costs and other measures of utilization.

Methods: Since 1996, Washington State has required all commercial insurance to cover licensed CAM providers, including acupuncturists, massage therapists, naturopathic physicians, and chiropractors. We analyzed insurance claims from 1997, 2000, and 2002 for two of the state’s largest underwriters.

Results: Among the approximately 500,000 enrollees in each year, the proportion with claims for any kind of health care increased from 77.6% in 1997 to 82.8% in 2002. Claims for naturopathy, acupuncture, and massage (NAM) were made by 6.9% of claimants in 2002, up from 1.73% in 1997. Claimants for chiropractic treatment increased from 12.4% to 16.6 %. Even though the number of visits per enrollee for NAM were small in 2002 (.44/enrollee), they had increased almost 5 fold since 1997. In comparison, visits for conventional care increased by only 17% to 5.83/enrollee and visits for chiropractic increased by 15% to 1.0/enrollee. CAM represented 7.02 % of allowed outpatient insurance amounts for 1997 and 9.71 % for 2002.

Conclusions: The number of people using CAM has increased dramatically since 1997. The overall effect on insurance expenditures has been modest. Some of the newly covered services may be substitutes for chiropractic care (for which some coverage was available before 1996). More generous CAM benefit packages are planned after 2002, thus future utilization of these services should be followed.

Learning Objectives:

• To describe the trajectory of increased insurance claims for CAM providers.
• To understand the predictors of CAM use in an insured population.
• To judge whether CAM plays a substantial role in health care costs under the model of insurance financing for these services.

Keywords: Alternative Medicine/Therapies,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.