Study: Alternative and Complementary Medicine

Research Projects – Health

Project Overview–As a result of the increasing interest in alternative and integrative treatments (CAM) as seen in both the scientific community and popular media, a Project Oversight Group was formed to design and oversee a study with the goal of analyzing health care claim data on these treatments. Members of the group are:

• Lee Launer, Chair
• Michael Gross
• Thomas Snook
• Lori Weyuker
• Steven Siegel, SOA Staff Liaison

There has been anecdotal information for years that CAM therapies have lower utilization and cost than conventional treatments and that outcomes are at least as good. A motivating factor behind the study is to assess whether or not the economic part of this anecdotal information can be validated with a body of related claims data collected from insurance companies and managed care organizations.

As of September 2002, the SOA has received claims data for this study from two contributors. The first contributor, an employer type with 9,000 members, submitted data in the fall of 2001 and the research team of Kyle Grazier and Bill G'sell of the University of Michigan was contracted to prepare the data for analysis. A link to the researcher's report and commentary from the Project Oversight Group is in the next section. The second contributor, a major health plan with over a million members, submitted data in July 2002 and this data will be analyzed in the near future.

Data from additional contributors is expected in the next few months. Data collection is an essential element of this effort and the Collaboration for Healthcare Renewal (CHRF), a national, non-profit organization interested in the assessment of the impact of integrative medicine, has provided assistance through its membership contacts. The SOA would welcome further data contributions from insurance and managed care organizations that offer coverage for CAM treatments. For more details, please contact Steven Siegel, SOA Research Actuary.

It is important to recognize that the report described in the next section is based upon only the first data submission and while the observations are of interest, the Project Oversight Group was unable to develop any credible conclusions based upon this data alone. As more data is obtained and analyzed, the group will distribute further reports along with observations and conclusions that it believes are sound.

Commentary and above Link:

In doing so, the group recognized the limitations of the report's findings because of the small amount of data studied. The group is using this data source and report primarily as a vehicle for becoming familiar with the content of the data and for designing report formats that will be used for future data sources.

The following observations were made with respect to Data Source 1:
About 4% of Data Source 1's members used Chiropractic and less than 1% used Acupuncture services during each year of the study. This is consistent with the expectations of the Project Oversight Group.

• CAM users were primarily adults.
• CAM–only users were primarily male and had the lowest average medical claim costs.
• Users of both CAM and conventional medical services had the highest average medical claim costs.
• For members continuously enrolled during the three years of the study period, CAM utilization deceased from year 1 to year 2, and from year 2 to year 3.

Because of the small amount of data, the group was unable to draw any firm conclusions from these observations.

Future Plans for the Study

• The Project Oversight Group is designing a simple longitudinal study using Data Source 1, to look for year-by-year patterns of CAM and conventional medical utilization among members who were enrolled for all three years of the study period. As with the Final Report, the longitudinal study is considered to be a vehicle for understanding the data rather than a source of credible conclusions.
• Other data sources will be studied including one that has already been submitted to the Society. It is hoped to build a credible volume of experience in order to derive frequencies and unit costs for common types of CAM services and make observations/draw conclusions concerning the economic relationship of CAM used alone or with conventional medicine as compared to conventional medicine only.
• The group is studying the possibility of applying risk adjusters to future data sources. The purpose would be to normalize for health status in addition to demographics of the groups being analyzed. In addition, the group would like to determine the relationship, if any, between CAM utilization and measures of health status. Although risk adjusters can include predictive applications, it is not anticipated that risk adjusters will be used to predict CAM utilization based on prior medical service utilization.