Can CAM Help Slow the Growth in National Health Care Spending?

posted by Pivotal Health Solutions on Friday, October 17, 2014

Health care spending is an increasingly hot topic, even as the Affordable Care Act extends health care to millions of previously uninsured Americans. One solution? Complementary medicine, such as chiropractic and massage. According to a recent article in Massage Today, hospitals and health care facilities could look to CAM as a way to help slow national health care spending.

A recent report from Health Affairs entitled, "U.S. Spending on Complementary and Alternative Medicine During 2002-2008 Plateaued, Suggesting Role in Reformed Health System," sheds light on some interesting spending trends for CAM.

According to study authors Matthew Davis, Brook Martin, Ian Coulter and William Weeks, CAM is an approximately $9 billion market in the U.S. each year, which they say is equal to three percent of national ambulatory health care expenditures. The authors examined trends in the demand for CAM as reported in the Medical Expenditure Panel Survey during 2002 through 2008. According to the report, the authors believe that, "should some forms of complementary and alternative medicine be proven more efficient than allopathic and specialty medicine, the inclusion of complementary and alternative medicine providers in the new delivery systems such as accountable care organizations could help slow growth in national health care spending."

In terms of national spending on CAM, "inflation-adjusted expenditures on chiropractic care increased 11 percent from $6.2 billion in 2002 to $6.9 billion in 2008. Inflation-adjusted expenditures on acupuncture, massage therapy and other complementary and alternative medicine services were stable." Another interesting finding was the amount spent per patient on specific services. The authors found that "the mean annual inflation-adjusted expenditure per user decreased for acupuncture (from $260 to $325) and other complementary and alternative medicine services (from $301 to $214), while it increased for chiropractic care (from $447 to $582) and massage therapy (from $259 to $305)."

According to the study, the number of CAM users held steady except for one specific service: acupuncture grew by 16 percent from 950,000 in 2002 to 1.1 million in 2008. Overall, the number of adults who visited a CAM provider at least once during the year increased by six percent, from 15.2 million in 2002 to 16.1 million in 2008. "Chiropractic care accounted for 77 percent to 82 percent of total ambulatory visits to complementary and alternative medicine providers from 2002 to 2008, while massage therapy accounted for 10 percent to 14 percent; acupuncture 4 percent to 6 percent and other services, 3 percent to 4 percent."

The authors acknowledge the historically poor communication between CAM providers and providers of other medical services. However, the authors note that new opportunities to stabilize spending could come from including CAM services in accountable care organizations. "Considering that complementary and alternative medicine appears to be relatively inexpensive when compared to allopathic medicine, if medical care providers are willing to collaborate with local complementary and alternative medicine service providers, offering at least some complementary and alternative medicine services could help accountable care organizations achieve their objectives."

In conclusion, the authors believe that, "as health care policy makers, payers and other stakeholders attempt to reduce waste in health care systems, they should recognize that excluding currently covered complementary and alternative medicine services would, at best, produce only meager cost savings. Operating under more free-market conditions, the pricing of complementary and alternative services appears to be more self-regulating than that of the conventional health care sector. This difference suggests that payment systems that encourage consumers to make educated decisions under the constraint of a budget may help constrain health care spending growth.

"Examination of the U.S. complementary and alternative medicine market is useful in understanding consumer response to a more cash-based health care economy, which can inform future benefit design. If certain types of complementary and alternative medicine services are proven to be efficient in managing health conditions, those who provide these services may find opportunities to participate in new delivery system models such as accountable care organizations, resulting in a more collaborative approach to health care delivery."