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NTIS 바로가기대한예방한의학회지 = Journal of Society of Preventive Korean Medicine, v.23 no.1, 2019년, pp.1 - 13
김주철 (대한한의사협회 한의학정책연구원) , 이은경 (대한한의사협회 한의학정책연구원) , 김동수 (한국한의학연구원 한의학정책연구센터)
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 analy...
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핵심어 | 질문 | 논문에서 추출한 답변 |
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미국의 보완대체의학 시장 성장에 영향을 주는 요인은 무엇인가? | 3억 USD(2017년 기준;Grand view research, 2018)의 약 18%를 차지하는 규모이다. 미국에서 보완대체의학 시장의 성장은 식이보충제(dietary supplement) 뿐만 아니라 요가, 침술, 에너지 요법(energy healing)의 성장에 기인한다1). 미국 성인 중 보완대체의학을 이용하는 사람은 2012년 현재 33. | |
미국의 민간의료보험은 어떻게 나눌 수 있는가? | 미국의 건강보험은 공적 건강보험, 민간의료보험으로 나누어지며, 공적 건강보험은 메디케어(Medicare), 메디케이드(Medicaid), 어린이 건강보험(Children’s Health Insurance Program, S-CHIP)과 군인보험(Military Health Care) 등으로 구성되며, 군인 보험은 재향군인 의료보장(Veterans Affairs, VA), 국방부 트라이 케어(Tricare)로 구분된다5). 민간의료보험은 가입형태에 따라 기업이나 고용주를 통한 가입(Employment-based Private Plan), 개인가입(Direct Purchase Private Plan), 오바마케어를 통한 가입으로 구분되며, 플랜 유형에 따라서는 HMO(Health Maintenance Orga-nization), PPO(Preferred Provider Organization), EPO(Exclusive Provider Organization), POS(Point of Service) 크게 4가지이다6). | |
침술보험을 청구할 수 있는 질환은 무엇인가? | 미국에서 침술은 메디케이드에서만 보장되며, 침술보험을 청구할 수 있는 종류는 4가지로 자침과 전침 사용 여부와 시술 시간에 따라 달라진다. 보험 청구에 적용되는 질환은 주마다 조금씩 다르나 일반적으로 통증, 요통이나 편두통, 그리고 오심(nausea)과 마취(anesthesia)의 대체법으로 사용될 때이다27). 1회당 최대 청구할 수 있는 보험 수가는 캘리포니아주는 2016년 기준 $5. |
Grand view research Inc. Complementary and Alternative Medicine Market. USA 2018.
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)
Korea institute of oriental medicine. Guide book of Korean medicine doctors's advance to the US. Ministry of health & walfare. 2015.
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
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Definition of complementary & alternative website. Complementary, Alternative, or Integrative Health: What's In a Name?. https://nccih.nih.gov/health/integrative-health
Definition of acupuncture website.. Acupuncture: In Depth. https://nccih.nih.gov/health/acupuncture/introduction
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.
Acupuncture coverage in medicare website. Acupuncture coverage - Medicare.gov. https://www.medicare.gov/coverage/acupuncture
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
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/
Acupuncture cover for veterans affair website. Butler VA Health Care System-Acu-puncture. https://www.butler.va.gov/services/Acupuncture.asp?_ga2.260543625.547489953.1553136467-1832815282.1553136467
Chiropractic coverage in medicare website. Coverage For Chiropractic Services - Medicare.gov. https://www.medicare.gov/coverage/chiropractic-service
Chiropractic coverage in medicaid website. Medicaid Benefits: Chiropractor Services. https://www.kff.org/medicaid/state-indicator/chiropractor-services/?currentTimeframe0&sortModel%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
Chiropractic coverage in veterans affairs website. Insurance Coverage of Chiropractic : Quick Facts. https://www.acatoday.org/Patients/Access-Coverage/Insurance-Coverage
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
Current maximum payment amount of california website. Benefits Grid-Acupuncture Services. https://www.cahealthwellness.com/members/medicaid/benefits-services/benefits-grid.html
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?qReimbursement+for+Acupuncture+Services+for+UnitedHealthcare+Community+Plan+&searchSearch
Chiropractic overview of california website. Chiropractic and Podiatry Coverage. https://www.cahealthwellness.com/newsroo m/chiropractic-and-podiatry-coverage.html
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.
Health insurance policy committee. meeting material 2018
Fan AY. "Obamacare" covers fifty-four million Americans for acupuncture as Essential Healthcare Benefit. J Integr Med, 2014;12 (4):390-393.
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/
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
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
Nccaom website. Stakeholder Input to Address the Opioid Crisis. https://www.finance.senate.gov/download/national-certification-commission-for-acupuncture-and-oriental-medicine
Acupuncture in veteran choice progran website. Acupuncture and the Veteran Choice Program. https://www.acu-na.com/acupuncture-andthe-veteran-choice-program/
Veterans affairs qualification standard website. Va handbook 5005/100. https://webcache.googleusercontent.com/search?qcache:E4b4GD2BwRsJ:https://www.va.gov/vapubs/viewPublication.asp%3FPub_ID%3D909%26FType%3D2+&cd1&hlko&ctclnk&glkr
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
Korea instutute of oriental medicine. Current state of institution and industry about complementary alternative medicine in Germany. 2018.
Oecd health data website. OECD Health Statistics 2018. https://stats.oecd.org/index.aspx?DataSetCodeHEALTH_STAT#
J Weeks. Influential U.S. Medical Organizations Call for Insurance Coverage of Non-Pharmacologic Approaches to Pain. JACM 2016;22(12):947-949
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
Ministry of Health and Welfare. Current state and future plan of health insurance coverage expansion. 2018.
Medicare Physician Fee Schedule. 2018. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/PFS-Relative-Value-Files-Items/RVU18A.html
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