Trends in Utilization of Acupuncture in the U.S. Health System, 2016-2022

Background: The Military Health System (MHS) has provided acupuncture since 2005 and, in 2014, delivered acupuncture to approximately 15,000 beneficiaries. However, no recent studies have assessed acupuncture in the MHS, despite new guidelines aiming to increase its provision. Methods: We identified acupuncture claims from the MHS Data Repository (MDR) for fiscal years (FY) 2016-2022, using bivariate analysis to determine demographics and number of visits. Descriptive statistics showed associated diagnoses, provider specialties, clinical settings, and number of military treatment facilities (MTFs) providing acupuncture. Trend analyses showed numbers of patients and MTFs providing acupuncture by FY. Results: During this period, 152,564 people received acupuncture, with greatest use among Army service, White race, and Senior Enlisted rank, for males in active duty aged 26-35 and females in nonactive duty aged 46-65. A cumulative 93.2% of diagnoses related to musculoskeletal and nervous system issues. The most common setting was family medicine clinics; ∼38% of patients received acupuncture from nonphysician providers. The number of MTFs providing acupuncture increased rapidly from 2016 to 2020, and more slowly from 2020 to 2022, while the number of visits peaked in 2019 before decreasing. Conclusions: Acupuncture use in the MHS expanded ∼2-fold among patients and 3-fold among facilities since 2014. Diagnoses are consistent with pain control, and there was a shift toward nonphysician providers. Promotion of acupuncture in the MHS was likely hampered by care shifts during the COVID-19 pandemic public health emergency. Further research should assess the long-term effect of these guidelines and the effectiveness of acupuncture in promoting service member retention.