Insurers have been signalling for some time they have concerns with claims for massage therapy. Recent podcasts and blogposts from Greenshield Canada and Benefits Canada may imply significant changes are coming.
1) Insurers acknowledge MT provides short-term pain relief. They want comparative studies to demonstrate more or less efficacy compared to exercise, a yoga class, mindfulness practice or “a nap”.
2) Insurers are skeptical of a broad scope of practice not linked directly to evidence or measured outcomes. They want treatment guidelines that estimate costs of treatment plans and deliver tangible benefits to claimants.
3) Insurers demand services claimed to be evidence-based and demonstrate efficacy.
4) Insurers imply claims reimbursement can contribute to exploitive business models geared to maximizing financial gain rather than better health outcomes. They want measures taken against fraud and exploitation
Without provincial health plan coverage of musculo-skeletal injuries, citizens rely heavily on employee benefits provided by their employer. Good insurer relations are key for massage therapists to ensure continued access by their patients. The MT profession needs to come up to speed and galvanize its representatives to ensure good insurer relations.
Regarding “up to speed”, following are a number of resources – from most recent to archived – to help you understand and articulate the issues, make informed statements when speaking to colleagues, and to ask your advocates in your professional association to act.
Insurers Signal Change in Massage Therapy Coverage (podcast) (June 2019)
Insurers Question the Value of Massage Therapy…A Signal of Changes to Come? (May 2019)
Consider the Insurer’s Perspective (February 2019)
Can Massage Therapists Improve Relations with the Insurance Industry? (podcast, February 2019)
Report on Health Benefits Misses the Point (May 2015)
Claims Crisis in Health Insurance (September 2013)