Effectiveness of CAM Therapies

A growing body of evidence shows that many CAM interventions are effective in treating or helping to treat a range of health conditions. However, insurance and managed care executives have indicated to the Commission that CAM services and products are not covered, or receive limited coverage, because there is not enough evidence of "medical effectiveness."

Understandably, health plan administrators and those who purchase health plans want to make sure that their limited dollars are spent on safe and effective health care services. In the face of ever-rising health care costs and the vicissitudes of the economy, purchasers and payers also want value and accountability for their investment. The addition of State mandated benefits, as well as the constant stream of new technologies, drugs, and treatment protocols, has left these parties cautious about expanding any health care benefits.

At the operational level, government agencies like the Centers for Medicare and Medicaid Services (CMS), insurers, and managed care organizations invest significant time and resources to determine which benefits are covered, for how long, which practitioners are authorized to perform the services, and how payment will be made. Except for chiropractic and, increasingly, acupuncture and massage therapy, much of CAM is not covered. The services that are covered are often accompanied by limitations, such as global visit limits that are unrelated to individual patient needs or course of treatment.

With the rising cost of health care and heightened sensitivity to price in the market place, the addition of new benefits is a major undertaking. Taken together, economic and market forces, as well as pressures to manage the use of services in today's health insurance world, are creating the need for more evidence of the clinical effectiveness of CAM interventions. Evidence of clinical effectiveness in the treatment of illnesses and injuries will form the basis for sound coverage and reimbursement policies for CAM.

The Commission strongly supports more health services research to establish the medical and clinical efficacy of CAM therapies. Because research dollars are limited, cooperative efforts between the public and private sectors are needed to identify and resolve methodological issues that challenge health services research and to establish research priorities.

In addition to research on safety and efficacy, health services research is needed to evaluate the outcomes of CAM interventions in improving health status, treating acute and chronic conditions such as with heart disease, diabetes, and HIV infection, and supporting the care of persons with life-threatening diseases such as cancer. Research and demonstrations are needed to develop and test models of providing CAM (including integrative and collaborative programs), to compare conventional and CAM approaches for the same condition, to test the effectiveness of individual and combined CAM interventions, to test CAM offered in conjunction with conventional therapies, and to conduct population-based studies. Likewise, research is needed on whether CAM, health promotion programs, and prevention efforts increase worker morale, reduce stress, lessen the incidence of workplace disabilities and workmen's compensation claims, shorten treatment duration for illness and injuries, and improve productivity. To maximize resources, vested parties should be brought together to develop a comprehensive, cohesive agenda. The parties would, at a minimum, identify priority questions for research and demonstrations, issues in applying common research methodologies, data needs, and ways in which the public and private sectors could coordinate their efforts. The parties will need to commit to carrying out this agenda and invest financial resources to build the needed research base. Participants should include the Department of Health and Human Services (DHHS), including the Agency for Health Research and Quality (AHRQ), the National Institutes of Health (NIH), CMS, the Health Resources and Services Administration (HRSA), DOD, VA, private research and other foundations, health industry associations, medical associations and experts, CAM associations and experts, and representatives for employers, States, and consumers.

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• What is CAM? • Overview • Convergence • Evolution< • Recent History • Consumer Use • Cancer • Chronic Pain • HIV Infection • Reasons • Conventional • Effectiveness • Differences • Major Types • NCCAM's Role • Definitions • Helpful Links
		Effectiveness of CAM Therapies A growing body of evidence shows that many CAM interventions are effective in treating or helping to treat a range of health conditions. However, insurance and managed care executives have indicated to the Commission that CAM services and products are not covered, or receive limited coverage, because there is not enough evidence of "medical effectiveness." Understandably, health plan administrators and those who purchase health plans want to make sure that their limited dollars are spent on safe and effective health care services. In the face of ever-rising health care costs and the vicissitudes of the economy, purchasers and payers also want value and accountability for their investment. The addition of State mandated benefits, as well as the constant stream of new technologies, drugs, and treatment protocols, has left these parties cautious about expanding any health care benefits. At the operational level, government agencies like the Centers for Medicare and Medicaid Services (CMS), insurers, and managed care organizations invest significant time and resources to determine which benefits are covered, for how long, which practitioners are authorized to perform the services, and how payment will be made. Except for chiropractic and, increasingly, acupuncture and massage therapy, much of CAM is not covered. The services that are covered are often accompanied by limitations, such as global visit limits that are unrelated to individual patient needs or course of treatment. With the rising cost of health care and heightened sensitivity to price in the market place, the addition of new benefits is a major undertaking. Taken together, economic and market forces, as well as pressures to manage the use of services in today's health insurance world, are creating the need for more evidence of the clinical effectiveness of CAM interventions. Evidence of clinical effectiveness in the treatment of illnesses and injuries will form the basis for sound coverage and reimbursement policies for CAM. The Commission strongly supports more health services research to establish the medical and clinical efficacy of CAM therapies. Because research dollars are limited, cooperative efforts between the public and private sectors are needed to identify and resolve methodological issues that challenge health services research and to establish research priorities. In addition to research on safety and efficacy, health services research is needed to evaluate the outcomes of CAM interventions in improving health status, treating acute and chronic conditions such as with heart disease, diabetes, and HIV infection, and supporting the care of persons with life-threatening diseases such as cancer. Research and demonstrations are needed to develop and test models of providing CAM (including integrative and collaborative programs), to compare conventional and CAM approaches for the same condition, to test the effectiveness of individual and combined CAM interventions, to test CAM offered in conjunction with conventional therapies, and to conduct population-based studies. Likewise, research is needed on whether CAM, health promotion programs, and prevention efforts increase worker morale, reduce stress, lessen the incidence of workplace disabilities and workmen's compensation claims, shorten treatment duration for illness and injuries, and improve productivity. To maximize resources, vested parties should be brought together to develop a comprehensive, cohesive agenda. The parties would, at a minimum, identify priority questions for research and demonstrations, issues in applying common research methodologies, data needs, and ways in which the public and private sectors could coordinate their efforts. The parties will need to commit to carrying out this agenda and invest financial resources to build the needed research base. Participants should include the Department of Health and Human Services (DHHS), including the Agency for Health Research and Quality (AHRQ), the National Institutes of Health (NIH), CMS, the Health Resources and Services Administration (HRSA), DOD, VA, private research and other foundations, health industry associations, medical associations and experts, CAM associations and experts, and representatives for employers, States, and consumers. Top of Page