DOI QR코드

DOI QR Code

미국에서의 침술과 카이로프랙틱 건강보험 급여 현황

A Study on Current Status of Acupuncture and Chiropractic Health Insurance in the United States

  • 김주철 (대한한의사협회 한의학정책연구원) ;
  • 이은경 (대한한의사협회 한의학정책연구원) ;
  • 김동수 (한국한의학연구원 한의학정책연구센터)
  • Kim, Juchul (Research Institute of Korean Medicine Policy, The Association of Korean Medicine) ;
  • Lee, Eunkyung (Research Institute of Korean Medicine Policy, The Association of Korean Medicine) ;
  • Kim, Dongsu (KM Policy Research Center, Korea Institute of Oriental Medicine)
  • 투고 : 2019.03.27
  • 심사 : 2019.04.19
  • 발행 : 2019.04.30

초록

Backgrounds : The market of Complementary Alternative Medicine(CAM) in the United State(U.S.) accounts for a large proportion of the global CAM market and has a high growth rate. The recent introduction of Obama Care has brought the change in the health insurance system for CAM, and we need to analyze it for its implication to Korean system. Objectives : The purpose of this study is to investigate the current status of acupuncture and chiropractic health insurance in the U.S., and to draw implications for expanding the health insurance coverage for Korean traditional medicine through the comparison between the U.S. and Korean health insurance systems. Methods : We examined the data through the literature search and from the websites of both U.S. government departments and related organizations for the health insurance policy. Based on the collected data, we analyzed its CAM health insurance system in Korea. Results : The acupuncture covered by public health insurance in the U.S. has a limit in the number of treatments and a range of applied diseases compared with Korea. In addition, the practice of acupuncture is not subdivided. However, the chiropractic in the U.S. which also has a limited number of coverage and only three categories of practices are similar to that of Korea. Conclusions : Although the use of CAM by public health insurance is not active in the U.S., but the organizations such as Veterans Health Administration in Vermont is already discussing the use of acupuncture to solve the problem of opioid overuse. Thus Korea also needs to discuss to promote the expansion of the insurance system for CAM.

키워드

참고문헌

  1. Grand view research Inc. Complementary and Alternative Medicine Market. USA 2018.
  2. TC Clarke, LI Black, BJ Stussman, PM Barnes, RL Nahin. Trends in the Use of Complementary Health Approaches Among Adults: United States, 2002-2012. National Health Statistics Reports 2015;(79)
  3. Korea institute of oriental medicine. Guide book of Korean medicine doctors's advance to the US. Ministry of health & walfare. 2015.
  4. B Lim. Policies on Complementary and Alternative Medicine in the United States-Focusing on Licensing and Insurance-. Kor. J. Oriental Preventive Medical Society 2010; 14(1):137-149
  5. U.S. department health & human services website. Health Insurance. https://www.hhs.gov/programs/health-insurance/index.html
  6. Healthcare website. Health insurance plan and network types: HMOs, PPOs, and more. https://www.healthcare.gov/choose-a-plan/plan-types/
  7. Barnett, Jessica C., et al. Current Population Reports, P60-260, Health Insurance Coverage in the United States: 2016. U.S. Government Printing Office, Washington, DC, 2017.
  8. Census website. Health Insurance Coverage in the United States: 2016. https://www.census.gov/library/publications/2017/demo/p60-260.html
  9. Medicare program website. Medicare Program-General Information. https://www.cms.gov/Medicare/Medicare-General-Information/MedicareGenInfo/index.html
  10. Medicare part a cover website. What Part A covers. https://www.medicare.gov/what-medicare-covers/what-part-a-covers
  11. Medicare part a cover website. What Part B covers. https://www.medicare.gov/what-medicare-covers/what-part-b-covers
  12. Medicare part c cover website. Medicare Advantage Plans cover all Medicare services. https://www.medicare.gov/what-medicarecovers/what-medicare-health-plans-cover/medicare-advantage-plans-cover-all-medicare-services
  13. Medicare part d cover website. Drug coverage (Part D). https://www.medicare.gov/drugcoverage-part-d
  14. Veterans affairs benfits website. About VA Health Benefits. https://www.va.gov/health-care/about-va-health-benefits/
  15. Henry J Kaiser Family Foundation, Employer Health Benefits 2018 Annual Survey "Employer Health Benefits". 2018)
  16. Jessica C. Barnett and Edward R. Berchick (2017), Health insurance statistics 2016
  17. Definition of complementary & alternative website. Complementary, Alternative, or Integrative Health: What's In a Name?. https://nccih.nih.gov/health/integrative-health
  18. Definition of acupuncture website.. Acupuncture: In Depth. https://nccih.nih.gov/health/acupuncture/introduction
  19. Nahin RL, et al. Insurance coverage for complementary health approaches among adult users: United States, 2002 and 2012. NCHS data brief, no 235. Hyattsville, MD: National Center for Health Statistics.
  20. Acupuncture coverage in medicare website. Acupuncture coverage - Medicare.gov. https://www.medicare.gov/coverage/acupuncture
  21. Six state to cover acupuncture for medicaid website. New Medicaid rule will further open acupuncture services to 108,000 Ohio patients with low back pain, migraines. https://www.cleveland.com/healthfit/2017/12/new_medicaid_rule_will_further.html
  22. Maine & vermont medicaid acupuncture pilot project result website. As the opioid crisis grows, states are opening Medicaid to alternative medicine. https://www.statnews.com/2018/01/17/medicaid-opioids-alternative-medicine/
  23. Acupuncture cover for veterans affair website. Butler VA Health Care System-Acu-puncture. https://www.butler.va.gov/services/Acupuncture.asp?_ga=2.260543625.547489953.1553136467-1832815282.1553136467
  24. Chiropractic coverage in medicare website. Coverage For Chiropractic Services - Medicare.gov. https://www.medicare.gov/coverage/chiropractic-service
  25. Chiropractic coverage in medicaid website. Medicaid Benefits: Chiropractor Services. https://www.kff.org/medicaid/state-indicator/chiropractor-services/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
  26. Chiropractic coverage in veterans affairs website. Insurance Coverage of Chiropractic : Quick Facts. https://www.acatoday.org/Patients/Access-Coverage/Insurance-Coverage
  27. Acupuncture services of bluecross blueshield website. Acupuncture: What does health insurance cover?. https://www.bluecrossmn.com/health-plans-101/acupuncture-what-does-health-insurance-cover
  28. Current maximum payment amount of california website. Benefits Grid-Acupuncture Services. https://www.cahealthwellness.com/members/medicaid/benefits-services/benefits-grid.html
  29. Current maximum payment amount of ohio website. Reimbursement for Acupuncture Services for UnitedHealthcare Community Plan Medicaid Members in Ohio. https://www.uhcprovider.com/en/search-results.html?q=Reimbursement+for+Acupuncture+Services+for+UnitedHealthcare+Community+Plan+&search=Search
  30. Chiropractic overview of california website. Chiropractic and Podiatry Coverage. https://www.cahealthwellness.com/newsroo m/chiropractic-and-podiatry-coverage.html
  31. Ministry of Health and Welfare. Health Insurance medical procedure Insurance. Non-Insurance list table and Insurance relative value score Part 2 Chapter 14 korean medicine treatment fee. 2019.
  32. Health insurance policy committee. meeting material 2018
  33. Fan AY. "Obamacare" covers fifty-four million Americans for acupuncture as Essential Healthcare Benefit. J Integr Med, 2014;12 (4):390-393. https://doi.org/10.1016/S2095-4964(14)60035-2
  34. Ending america's opioid crisis website. President Donald J. Trump is Taking Action on Drug Addiction and the Opioid Crisis. https://www.whitehouse.gov/briefings-statements/president-donald-j-trump-taking-action-drug-addiction-opioid-crisis/
  35. Helpful materials for patients website. Opioids for Acute Pain: What you need to know, Centers for Disease Control and Prevention. https://www.cdc.gov/drugoverdose/patients/materials.html
  36. The american college of physicians website. American College of Physicians issues guideline for treating nonradicular low back pain, American College of Physicians. https://www.acponline.org/acp-newsroom/american-college-of-physicians-issues-guideline-for-treating-nonradicular-low-backpain
  37. Nccaom website. Stakeholder Input to Address the Opioid Crisis. https://www.finance.senate.gov/download/national-certification-commission-for-acupuncture-and-oriental-medicine
  38. Acupuncture in veteran choice progran website. Acupuncture and the Veteran Choice Program. https://www.acu-na.com/acupuncture-andthe-veteran-choice-program/
  39. Veterans affairs qualification standard website. Va handbook 5005/100. https://webcache.googleusercontent.com/search?q=cache:E4b4GD2BwRsJ:https://www.va.gov/vapubs/viewPublication.asp%3FPub_ID%3D909%26FType%3D2+&cd=1&hl=ko&ct=clnk&gl=kr
  40. Robert T Davis, Gary Badger, Kristina Valentine, Alexander Cavert, and Remy R Coeytaux(2018). "Acupuncture for Chronic Pain in the Vermont Medicaid Population: A Prospective, Pragmatic Intervention Trial", Glob Adv Health Med, 2018.7
  41. Korea instutute of oriental medicine. Current state of institution and industry about complementary alternative medicine in Germany. 2018.
  42. Oecd health data website. OECD Health Statistics 2018. https://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT#
  43. J Weeks. Influential U.S. Medical Organizations Call for Insurance Coverage of Non-Pharmacologic Approaches to Pain. JACM 2016;22(12):947-949
  44. Essential Health Benefits website. 10 Essential Health Benefits Insurance Plans Must Cover Under the Affordable Care Act. https://familiesusa.org/blog/10-essential-health-benefits-insurance-plans-must-cover
  45. Ministry of Health and Welfare. Current state and future plan of health insurance coverage expansion. 2018.
  46. Medicare Physician Fee Schedule. 2018. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/PFS-Relative-Value-Files-Items/RVU18A.html