Insurers signal changes to Massage Therapy Claims

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.

Specifically:
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 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)

Manage Massage Therapy’s Reputation in the Marketplace (June 2015)

Report on Health Benefits Misses the Point (May 2015)

Claims Crisis in Health Insurance (September 2013)

Insurance Coverage for Massage Therapy: Going…going…gone? (July 2012)

Consider the Insurer’s Interests, Perspective and Experience

In mid-December 2018, Andrew Lewarne, Executive Director of the Registered Massage Therapists’ Association of Ontario (RMTAO) met with Greenshield Canada (GSC) representatives David Willows – Chief Innovation and Marketing Officer, and Ned Pojskic, Leader of Pharmacy & Health Provider Relations.  Lewarne requested the meeting regarding a provocative Autumn 2010 news post on the Greenshield Canada website, Elephant in the (Waiting) Room https://www.greenshield.ca/en-ca/news/post/the-elephant-in-the-waiting-room.

Lewarne expressed “firm objection to the article’s false and misleading messages and emphasized the important role of massage therapy in health care.”[1]  Willows and Pojskic agreed to adjust some of the inflammatory wording but declined to remove the post.  Promisingly, the GSC pair took RMTAO materials highlighting research in massage therapy, and agreed on future meetings which include RMTs with higher level education and research perspective.

On the heels of the RMTAO objection, Deetria Egeli, RMT and board member with the Registered Massage Therapists’ Association of British Columbia (RMTBC) submitted a January 4th, 2019 letter to address the angst suffered by RMTBC’s membership on this same issue. https://gallery.mailchimp.com/d386e1f0c4cfc3315ec6794a8/files/224a0ad8-a18a-4944-afa8-ad91569a4acc/Greenshield.Letter_D.Egeli_.pdf?fbclid=IwAR3RT_tSRpVv3TxE1mSiNxBGpMVBgUZw92_WLnBunWMMygayrVFxbEKTuko

Egeli’s letter reflected her perspective as a practitioner, highlighting populations she has served and conditions treated, with an emphasis on her rigorous education and training.  Egeli provided several examples of massage therapy research, and posed the question to GSC, “(have you asked) why patients value massage therapy?”  Egeli challenges the “deliberate and discriminatory” statements made by GSC in the Elephant post.  Egeli assures the insurers, “I do not see anyone for hedonistic purposes”….

Read the full article plus seven other helpful links and a podcast on the subject at the Massage Therapy Canada website.

[1] The Friday File, RMTAO, December 14, 2018