Employees take advantage of alternative benefits
Employees take advantage of alternative benefits
Chiropractic most popular, followed by massage
With more and more managed care organizations offering benefits to cover alternative medicine, are employees actually using them? The answer at Norwalk, CT-based Oxford Health Plans is a resounding "yes."
Oxford launched its program in January 1997, offering the following:
• a network of alternative medicine providers;
• an alternative medicine insured rider benefit;
• an alternative medicine advisory board;
• "Living Balance" dietary supplements and natural products available at a discount;
• educational seminars on issues such as women’s health, stress reduction, herbs/botanicals, homeopathics and mind/body healing;
• Oxford’s on-line "Conventional & Alternative Remedies Encyclopedia (C.A.R.E.)."
While a formal study of utilization rates has just begun, anecdotal information leads Oxford officials to believe between 35% and 40% of covered employees are using the benefits.
This is no surprise to James N. Dillard, MD, DC, C.Ac (certified acupuncturist), Oxford’s medical director for the alternative medicine program. "The new benefits were very much driven by the desire on the part of our members, and also our employees, to have these services available to them," he notes.
Already using alternatives
In fact, notes Dillard, an Oxford member survey conducted two years ago found that one-third of the employees were already using one or more forms of alternative medicine. "We went a step further," he says. "We found out that 75% of our members wanted the health plan to embrace it." The four most frequently mentioned services, he says, were chiropractic, acupuncture, yoga, and massage. In terms of current utilization, he adds, the most popular alternative treatment is chiropractic, followed by massage.
There is a financial incentive even for those employees whose employer has not opted for the rider which allows employees to see an alternative care provider for just a co-pay. "That [rider] enhancement covers about 200 large employee groups a very small part of our total membership," says Dillard. "But we have standard benefits for chiropractic, for example; they are considered to be specialists in our network. Massage usage is available at a special rate."
In other words, he explains, any of Oxford’s 1.9 million members can access an alternative medicine provider and pay the "Oxford rate." This standardized rate guarantees the patient a reasonable fee for service, says Dillard. "Even though this does not represent an insured benefit, it’s a step up from what they were doing," he asserts. "They can go to a certified acupuncturist and know they’re getting a good provider, and get a high-quality good deal." Ultimately, he predicts, Oxford will move to insured benefits for all provider types.
Data gathered through careful examination
In order to get more specific data on utilization and outcomes, Oxford has teamed up with David M. Eisenberg, MD, and his researchers at Beth Israel Deaconess Medical Center at Harvard Medical School in Boston, to examine patterns of use, clinical outcomes, perceived effectiveness, cost, safety, and satisfaction relating to alternative medical care delivered through Oxford’s alternative medicine program.
"We can also look at the relationship between conventional medicine and alternative medicine, see which employees go to the hospital, which go to a hospital emergency room, what medicines they received, and so forth," says Dillard. "It’s an extremely rich research environment."
"We should have a lot of data put together in 1998," says Dillard. "This is very interesting stuff that nobody’s been able to do before. I suspect there will be multiple papers in big journals."
While the research program may provide valuable information, as far as the employee population is concerned, "We don’t have to prove this anyway," says Dillard.
"The health care consumer does not care what I say or what some professor says if they have a problem with their backs and they want to see an acupuncturist or a nutritionist, they’ll do that, no matter what I say or what the Surgeon General says," he asserts.
"So, let’s deal with that and give the people what they’ll use anyway, but let’s try to send them to someone good."
[Editor’s Note: For further information about Oxford’s alternative medicine programs, contact: Oxford Health Plans, 800 Connecticut Ave., Norwalk, CT 06854. Telephone: (203) 852-1442.]
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