News Release

Alternative therapy at state expense: Study looks at Medicaid coverage of nonconventional care for children

Peer-Reviewed Publication

Michigan Medicine - University of Michigan

ANN ARBOR, Mich. - Three quarters of states across the country pay for children in low-income families to receive some sort of alternative therapy through their Medicaid programs, a new study from the University of Michigan Health System finds. Though the total amount spent - about half a million dollars per state - is small relative to the programs' budgets, some states say they plan to expand their coverage in coming years.

The study looked at current coverage of alternative medicine for young Medicaid recipients ranging from chiropractic care and biofeedback to hypnosis and naturopathy, an alternative form of health care that focuses on natural healing methods.

The percentage of states that have agreed to pay for such services ranges from 74 percent for chiropractic down to 11 percent for naturopathy. Several states allow children to see an alternative practitioner as their primary care physician, or to see alternative providers under Medicaid's preventive screening, immunization, vision, dental and hearing program.

Terrence Steyer, M.D., a Robert Wood Johnson Clinical Scholar and lecturer in the U-M Departments of Family Medicine and Internal Medicine, conducted the survey of 46 state Medicaid programs to get a sense of how far the current trend toward alternative medicine had extended into state-funded pediatric care. He presented the results May 13 at the joint meeting of the Pediatric Academic Societies and the American Academy of Pediatrics.

As the nation embraces therapies that are more natural in origin, we must address the issue of quality of care and outcomes of alternative therapy, particularly when combined with conventional medicine," says Steyer. "Although this study shows the current spending is small, we hope it opens the door for further research on both reimbursed and out-of-pocket spending on such treatments."

Studies by other researchers have found that about 83 million Americans use at least one type of alternative therapy each year, including approximately 11 percent of children being seen in pediatric outpatient departments.

Alternative medicine is usually defined as care not generally taught at American medical schools nor provided at U.S. hospitals. It spans the spectrum from vitamins and herbal supplements to acupuncture and hypnosis.

State and federal agencies have regulated some alternative treatments, such as chiropractic, for many years, though licensing and other government oversight does not examine the effectiveness of the therapy.

As more states begin to license alternative providers such as naturopaths and acupuncturists, Medicaid plans surveyed by Steyer said they planned to consider adding additional coverage for alternative therapies in the next three years.

"We found that although the general public is turning to these approaches more and more at their own expense, state Medicaid programs do not routinely reimburse parents for their children's alternative care other than chiropractic," Steyer explains. "Still, this is a trend that warrants observing and further examination over time."

He especially hopes to continue his research by looking at which patients choose alternative providers for primary care, and by examining the quality and outcome of their care.

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