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Acupuncture for Medicare Beneficiaries with Chronic Low Back Pain: Access, Utilization, and Outcomes

Award Number: R01AT012615
ORGANIZATION: CENTER FOR DRUG EVALUATION AND RESEARCH, NIH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2024
PERIOD OF PERFORMANCE END DATE: 04/30/2027

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Acupuncture for Medicare Beneficiaries with Chronic Low Back Pain: Access, Utilization, and Outcomes - SUMMARY In 2020, following a thorough assessment of the scientific evidence on acupuncture, the Centers for Medicare & Medicaid Services (CMS) issued the decision to initiate coverage of acupuncture for management of chronic low back pain (cLBP) in Medicare beneficiaries. cLBP is a highly prevalent and difficult to manage condition, particularly in the highly vulnerable Medicare beneficiary population, and many patients with cLBP continue to receive prescriptions for analgesic medication despite evidence-based clinical guidelines that prioritize use of non-pharmacologic therapies, including acupuncture. Therefore, the CMS decision to cover acupuncture promises to improve the quality of care for Medicare beneficiaries with cLBP by providing an alternative to high-risk pharmacological interventions. The principal objective of this project is to assess the impact of the new CMS decision upon patient outcomes. Thus, the first aim of the project will be to compare safety, efficiency of care, and costs of care for Medicare beneficiaries receiving acupuncture as compared to pharmacotherapy for management of cLBP. Because the CMS decision came with restrictions on coverage that could impact equitable access to care, important project objectives will also include measuring the availability of acupuncture providers under Medicare, describing patterns and trends in utilization of acupuncture by Medicare beneficiaries, and determining facilitators and barriers to the use of acupuncture for both providers and patients. The approach to the first aim will be to analyze nationally representative Medicare claims data, using cohort, crossover cohort and interrupted time series designs. Availability and utilization will be evaluated through cross-sectional analysis of Medicare claims data combined with collected data on the supply of acupuncture providers. The approach to the assessment of facilitators and barriers for acupuncture will be to conduct focus groups and analyze the results using an immersion-crystallization approach. This study is expected to find that use of acupuncture by Medicare beneficiaries is associated with an equivalent or superior impact on the safety, efficiency of care, and costs of care for cLBP as compared to pharmacotherapy, and to demonstrate that the decision to allow coverage of acupuncture has had a positive impact on healthcare outcomes for Medicare patients with cLBP. The research is also expected to reveal provider and patient attitudes and beliefs about use of acupuncture under Medicare, and may reveal unwarranted variation in the availability and utilization of acupuncture under Medicare. The project is expected to make significant contributions to improvements in the care of patients with cLBP by strengthening the evidence in favor of the utilization of acupuncture by Medicare beneficiaries and hastening its systematic adoption in a way that ensures equitable patient access to high value spine care.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $530,949 )
2025	2025	SOUTHERN CALIFORNIA UNIVERSITY OF HEALTH SCIENCES	16200 AMBER VALLEY DR	WHITTIER	CA	90604	LOS ANGELES	USA	Research and Training in Complementary and Integrative Health	000	2	4/2/2025	NON-COMPETING CONTINUATION	$530,949
														Subtotal = $530,949

Issue Date FY: 2024 ( Subtotal = $576,138 )
2024	2024	SOUTHERN CALIFORNIA UNIVERSITY OF HEALTH SCIENCES	16200 AMBER VALLEY DR	WHITTIER	CA	90604	LOS ANGELES	USA	Research and Training in Complementary and Integrative Health	000	1	7/25/2024	NEW	$576,138
														Subtotal = $576,138

Grand Total All Awards = $1,107,087

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Acupuncture for Medicare Beneficiaries with Chronic Low Back Pain: Access, Utilization, and Outcomes

Award Number: R01AT012615

ORGANIZATION: CENTER FOR DRUG EVALUATION AND RESEARCH, NIH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/01/2024

PERIOD OF PERFORMANCE END DATE: 04/30/2027

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