Plateaued , Suggesting Role In Reformed Health System 08 − US Spending On Complementary And Alternative Medicine During 2002 Matthew

Complementary and alternative medicine services in the United States are an approximately $9 billion market each year, equal to 3 percent of national ambulatory health care expenditures. Unlike conventional allopathic health care, complementary and alternative medicine is primarily paid for out of pocket, although some services are covered by most health insurance. Examining trends in demand for complementary and alternative medicine services in the United States reported in the Medical Expenditure Panel Survey during 2002–08, we found that use of and spending on these services, previously on the rise, have largely plateaued. The higher proportion of out-of-pocket responsibility for payment for services may explain the lack of growth. Our findings suggest that any attempt to reduce national health care spending by eliminating coverage for complementary and alternative medicine would have little impact at best. Should some forms of complementary and alternative medicine—for example, chiropractic care for back pain—be proven more efficient than allopathic and specialty medicine, the inclusion of complementary and alternative medicine providers in new delivery systems such as accountable care organizations could help slow growth in national health care spending. H ealth care spending growth in the United States continues to be a national concern, despite having slowed somewhat in recent years. Therefore, health care policy makers, payers, and other stakeholders continue to consider strategies aimed at reducing, or at least containing, health care spending. One approach to reducing health care spending is to restructure benefits so as to reduce access to particular health care services. However, to avoid potential unintended consequences, such a strategy must be informed by knowledge of current health care spending. Complementary and alternative medicine has been immensely popular in the United States since the 1990s and is used regularly by more than one-third of adult Americans. Today, complementary and alternative medicine comprises an eclectic mix of self-administered products and activities including herbal medicines, homeopathic remedies, dietary supplements, and yoga, as well as provider-based services such as chiropractic care, massage therapy, and acupuncture. Largely because of their popularity among the public, some complementary and alternative medicine services are now offered as benefits in state Medicaid programs, Medicare, and private health insurance plans. For instance, chiropractic care—the most established complementary and alternative medicine service in the United States, with more than a 100-year history—is covered to some extent by most doi: 10.1377/hlthaff.2011.0321