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

> **NIH NIH R01** · SOUTHERN CALIFORNIA UNIV OF HEALTH SCIS · 2024 · $576,138

## Abstract

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.

## Key facts

- **NIH application ID:** 10977865
- **Project number:** 1R01AT012615-01A1
- **Recipient organization:** SOUTHERN CALIFORNIA UNIV OF HEALTH SCIS
- **Principal Investigator:** TODD A. MACKENZIE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $576,138
- **Award type:** 1
- **Project period:** 2024-08-01 → 2027-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10977865

## Citation

> US National Institutes of Health, RePORTER application 10977865, Acupuncture for Medicare Beneficiaries with Chronic Low Back Pain: Access, Utilization, and Outcomes (1R01AT012615-01A1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10977865. Licensed CC0.

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