What if Acupuncture Were Covered by Insurance for Pain Management? A Cross-Sectional Study of Cancer Patients at One Academic Center and 11 Community Hospitals.

Author: Liou KT1, Hung TKW2, Meghani SH3, Epstein AS4,5, Li QS1, Romero SAD1, Cohen RB6, Mao JJ1,5
1Bendheim Integrative Medicine Center, Memorial Sloan Kettering Cancer Center, New York, New York.
2Department of Hematology-Oncology, Olive View-UCLA Medical Center, Sylmar, California.
3Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
4Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
5Department of Medicine, Weill Cornell Medical College, New York, New York.
6Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Conference/Journal: Pain Med.
Date published: 2019 Apr 24
Other: Pages: pnz087 , Special Notes: doi: 10.1093/pm/pnz087. [Epub ahead of print] , Word Count: 265

OBJECTIVE: In response to the national opioid crisis, governmental and medical organizations have called for broader insurance coverage of acupuncture to improve access to nonpharmacologic pain therapies, especially in cancer populations, where undertreatment of pain is prevalent. We evaluated whether cancer patients would be willing to use insurance-covered acupuncture for pain.

DESIGN AND SETTING: We conducted a cross-sectional survey of cancer patients with pain at one academic center and 11 community hospitals.

METHODS: We used logistic regression models to examine factors associated with willingness to use insurance-covered acupuncture for pain.

RESULTS: Among 634 cancer patients, 304 (47.9%) reported willingness to use insurance-covered acupuncture for pain. In univariate analyses, patients were more likely to report willingness if they had severe pain (odds ratio [OR] = 1.59, 95% confidence interval [CI] = 1.03-2.45) but were less likely if they were nonwhite (OR = 0.59, 95% CI = 0.39-0.90) or had only received high school education or less (OR = 0.46, 95% CI = 0.32-0.65). After adjusting for attitudes and beliefs in multivariable analyses, willingness was no longer significantly associated with education (adjusted OR [aOR] = 0.78, 95% CI = 0.50-1.21) and was more negatively associated with nonwhite race (aOR = 0.49, 95% CI = 0.29-0.84).

CONCLUSIONS: Approximately one in two cancer patients was willing to use insurance-covered acupuncture for pain. Willingness was influenced by patients' attitudes and beliefs, which are potentially modifiable through counseling and education. Further research on racial disparities is needed to close the gap in utilization as acupuncture is integrated into insurance plans in response to the opioid crisis.

© 2019 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

KEYWORDS: Access; Acupuncture; Cancer; Disparities; Health Beliefs; Insurance; Pain

PMID: 31329938 DOI: 10.1093/pm/pnz087