Community, Commentary and Curriculum
for Massage Therapists

Extended Health Plans: Are We Too Reliant?
Posted: October 24, 2008   Feedback comment@mtcoach.com

What impact might health insurance coverage have on the income levels of massage therapists?  In a consumer panel survey by Collis & Reed, three-quarters of massage therapy patients surveyed reported using their extended health care benefits to pay for their massage therapy treatments. 

With 75% of massage therapy patients utilizing their extended health care benefits to access massage therapy, of course we would be concerned with developments in the extended health insurance industry.  According to the Aventis Health Care Survey 2001 – Canadians and Their Health Care Benefits, 15% of benefit-users say their benefit plans have gotten worse over the past 5 years.  Only 24% of respondents would pay a higher portion to maintain their benefits.

“Despite their apparent willingness to pay more, if required, to maintain benefit coverage, Canadian employees seem to have lingering concerns about their plan.  Most respondents agree that their employer is more concerned about limiting costs than ensuring that the best health benefits are available to them”.  Further “more than half (55%) of employees feel they don’t have any say in their employee healthcare benefit plan.”

“Drug coverage continues to be the most valued benefit among Canadian employees.  Six out of 10 respondents agree that if they could have only one benefit, they would choose their prescription drug coverage above all others”.¹

In this report, dental and vision care were also cited as priorities.  If employees had a fixed amount of health care dollars to spend in their plan, and they had a choice between drug therapy, dental, vision care, and massage therapy, what do we suppose they would be most likely to preserve?  Consider even the implications if workplace coverage was scaled back just 20%.  How would this affect the income of massage therapists, given our current heavy reliance on extended health benefits?

Prior to January 1, 2002, all citizens of British Columbia could access massage therapy under the medical services plan.  In efforts to reduce expenses, the provincial government nixed massage therapy coverage from the medical services plan, except for supplementary patients.  With health care costs rising, and a struggle by most provinces to overcome a chronic deficit, it is unlikely we will see access by massage therapists to public health funding any time soon.

How About Auto-Insurance and WSIB?

Another level of third party reimbursement for massage therapy treatment is auto insurance and WSIB, or worker's compensation insurance.

The Collis & Reed survey in Ontario reported that at least 72% of massage therapists have had patients pay via their auto insurance for injuries sustained in a motor vehicle collision.  Therapists stated that, on average, they estimate auto insurance claims form about 11% of their business. 

A number of legislative changes may have caused decreased access for massage therapists to the auto insurance rehabilitation billing.  In Alberta, the introduction of Diagnostic and Treatment Protocols call for enhanced skill-sets by massage therapists who treat persons injured in motor-vehicle collisions.

“The new Protocols were designed around evidence-based medicine, meaning the conscientious, explicit and judicious use of current best practice in making decisions about the care of the patient, integrating individual clinical expertise with the best available external clinical evidence from systematic research. The information will be monitored on an ongoing basis to track outcomes for patients and effectiveness of the treating in accordance with the protocols.

If massage therapy does not prove effective, we may lose the opportunity to participate in future funding schemes for treatments of WAD (whiplash-associated disorders) injuries…we must finely tune our assessment skills, follow the most proven techniques available to us and then accurately document the results in a manner that can be included in the data collection and analysis process.  This pool of data will be reviewed on an ongoing basis by the government to evaluate the efficacy and cost-efficiency of the care provided.”²

Auto insurers have been looking for ways to reduce their costs in rehabilitation.  The following quote was taken from the Insurance Bureau of Canada’s website: 

“Although property and casualty insurers every year spend more than $1 billion on medical fees and rehabilitation costs, there is little confidence within the industry that all of this money is well spent. Insurers believe that the industry needs a system for ensuring that insurers and claimants are receiving good value. The (property and casualty) insurance industry is the largest direct funder of rehabilitation services in Canada.

Auto insurance health care levies are a growing source of funds for provincial health care systems. Medical services funded by auto insurers are typically more costly per treatment and frequently involve more treatments with longer time frames to achieve the best possible health status for each patient, compared with workers' compensation or provincial medical plans. This evidence raises doubts about the value of the current system of caring for traffic accident victims.

The industry is working with health care service providers and other stakeholders to ensure that medical and rehabilitation resources are used efficiently to help victims of automobile accidents recover as well as possible, as quickly as possible.

While there has been a trend of fewer road crashes and fewer accident victims, paradoxically the number of crash victims receiving treatment has risen – with persistent high average costs of treatment. More intensive and costly rehabilitation treatment often does not appear to contribute to better outcomes for road accident victims.”³

It appears that a significant source of massage therapists’ income - that from extended health benefits and auto insurance – may be in danger of continued reductions.

WSIB (worker's compensation funding) has made great strides in funding for massage therapy in Ontario, with an increase to $50 per treatment and the Programs of Care which pay based on the delivery of the program, not individual treatments.

The biggest challenge in accessing this funding is to convince medical doctors to refer their patients to massage therapists when these patients show up with a work-related claim.

In our next segment, we look at the impact of the spa industry and franchise-based massage businesses on how massage practitioners practice.  dqd

© 2009, Donald Q. Dillon, RMT.  All Rights Reserved.

No part of this article may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

Feedback comment@mtcoach.com

1 Aventis Health Care Survey 2001 – Canadians and Their Health Care Benefits, pp 10-13

2 What Do MVA Reforms Mean to Massage Therapists?  A document from the Massage Therapist Association of Alberta

3 www.ibc.ca

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