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 Journal Article


Authors: Liou, K. T.; Hung, T. K. W.; Meghani, S. H.; Epstein, A. S.; Li, Q. S.; Romero, S. A. D.; Cohen, R. B.; Mao, J. J.
Article Title: 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
Abstract: 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: pain; insurance; acupuncture; access; disparities; health beliefs; cancer
Journal Title: Pain Medicine
Volume: 20
Issue: 10
ISSN: 1526-2375
Publisher: Oxford University Press  
Date Published: 2019-10-01
Start Page: 2060
End Page: 2068
Language: English
DOI: 10.1093/pm/pnz087
PUBMED: 31329938
PROVIDER: scopus
PMCID: PMC6784742
DOI/URL:
Notes: Article -- Export Date: 2 March 2020 -- Source: Scopus
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MSK Authors
  1. Andrew Saul Epstein
    121 Epstein
  2. Jun J Mao
    157 Mao
  3. Sally Ann Dominick Romero
    17 Romero
  4. Qing Susan Li
    56 Li
  5. Kevin Liou
    23 Liou