Major U.S Health Insurers Turn to Complementary Alternative Medicine
From Natural Healthline by Peter Barry Chowka |
Exactly four years ago this month, a seminal study published in the New England Journal of Medicine (January 29, 1993) found that in 1990, Americans made an estimated 425 million visits to providers of complementary alternative medicine. In contrast, Americans that year made only 388 million visits to U.S. primary care providers (MDs). David Eisenberg, MD, the director of alternative medical research at Beth Israel Hospital in Boston and Harvard Medical School and the principal author of the study, also estimated that Americans in 1990 spent $13.7 billion for alternative therapies -- most of it out of pocket. It is increasingly clear, according to knowledgeable observers such as James Gordon, MD, chair of the Program Advisory Council of the NIH's Office of Complementary and Alternative Medicine (OACM), that Americans' utilization of CAM is increasing yearly and is undoubtedly greater than the 1990 figures.
In a noteworthy sign this month that the explosive growth of CAM is moving more into the mainstream of medical economics, Oxford Health Plans, Inc. became the first major U.S. health provider to offer comprehensive coverage at pre-negotiated rates for a range of alternative health care providers, including acupuncturists, chiropractors, naturopathic physicians, nutritionists, massage therapists, and yoga instructors. Unlike other health care companies which cover some forms of alternative healing, however, Oxford's Alternative Medicine Program does not require a referral by the primary care physician. Oxford's providers must hold a professional license in the state they practice in, commit to continuing education in their discipline, demonstrate clinical expertise in two consecutive years of work experience, and undergo a site visit evaluation before becoming part of the program.
"The population of this country is saying there are more professionals out there to access," Hasaan Rifaat, MD, the Oxford executive who initiated the plan, told Reuters in an article published January 6. Rifaat cited an Oxford survey, which echoes the findings of Eisenberg, that 33 percent of its members were already receiving some form of alternative care. "It is an important responsibility for a health plan to ensure that we are promoting a combination of alternative and traditional [conventional] care," Rifaat added.
Oxford is offering its nearly 1.5 million members in New York, New Jersey, and Connecticut a variety of choices to supplement its "traditional" [i.e., conventional] packages. Recently, Oxford added to its site on the World Wide Web a major, informative subsection on its Alternative Medicine Program. While Oxford is currently the only health plan to offer such comprehensive alternative medical coverage including such a prominent, well-focused, and positive presentation about it on the Web, a number of other providers are now covering therapies from midwifery to massage, spurred by growing consumer demand.
"This is a member-driven world and we are responsive to what our members are asking for," said Laura Rohde, a spokeswoman with Kaiser Permanante, Inc., the oldest and largest group model health maintenance organization (HMO) in the world. Kaiser currently reimburses its seven million members in 16 states and the District of Columbia for nutritional counselling, yoga classes, and acupuncture. "We see it [CAM] as an important trend we need to pay attention to," Rohde said.
According to the Reuters article, economics is driving the insurance companies' interest in medical alternatives: "The recent inclusion of these therapies in health care plans reflects both an attempt to rein in spiralling costs, and good business sense on the part of providers."
It's also about competition and choice. According to health care analyst John Penshorn, "Health plans need to market themselves in a way that differentiates them from the competition. If you offer a broader product line you will better satisfy existing members and be more attractive, on the balance, to new members." Penshorn noted that the average employee contribution for health care premiums rose to 32 percent in 1994 from 24 percent in 1991, an indication that employees are increasingly involved in making decisions about health care.
"Any health plan in this day and age would be foolish not to look into alternative medicine to remain competitive," commented Kevin Davitt, a spokesman with Health Insurance Plan of Greater New York (HIP), another old-line, major HMO. HIP began covering member visits to acupuncturists about two years ago.
The Reuters article concluded, tellingly, that "Besides appealing to current and potential members, alternative services also make sense from a broader, economic point of view. The services tend to emphasize prevention and are generally cheaper than conventional medicine, which more often requires high-tech equipment and expensive drugs, experts said."
Links mentioned in this article. Haven't had any success connecting yet, though...
Oxford Health Plans
Oxford's Alternative Medicine Program
Kaiser Permanente
Here's a more extensive list of insurance companies that love Acupuncture.
Acupuncture.com |