The time to integrate alternative healthcare services into traditional HMO care has arrived, according to two major studies conducted by alternative care providers this year.
The most recent nationwide survey by the Stanford Center for Research in Disease Prevention, released last month, found that more than 56 percent of consumers believe their health plan should cover complementary and alternative medicine.
Moreover, consumers are willing to spend an additional $15.41 per month to integrate the most popular alternative treatments -chiropractic, acupuncture and massage therapy.
For health plans that do integrate alternative services into their standard coverage, the marketing opportunities are tremendous, especially during Fall open enrollment when employees are selecting health plans, says Kevin Buron, VP of marketing, sales at Landmark Healthcare, a managed alternative care company in Sacramento, Calif.
According to a study commissioned by Landmark and released early this year, 36 percent of consumers believe alternative care is "somewhat important" in selecting a health plan and 31 percent believe it is very important.
Alternative integration is most prevalent in the Northeast and West regions and least prevalent in the Midwest, South and parts of the East Coast, says Buron.
The Cost of Integration
Most health plans are taking a conservative approach. They are adding alternative services to their menu of healthcare benefits through "discount-only" methods, by which HMOs contract with alternative managed care providers and offer some of their members discounts on alternative services.
Discount-only options can cost health plans $.001 to.10 per month per member, according to Buron. This approach is problematic and frustrating for physicians who want to make alternative care referrals, however, because health plans don't offer the discount options to all of their members.
Health plans have two more progressive integration options -underwriting alternative benefit packages and incorporating alternative services as a core benefit to all HMO members.
These options offer the most direct access to alternative care and position the health plan as a fully integrated insurer, but the costs are significantly higher.
For instance, to add 20 visits of acupuncture and chiropractic care a month to a traditional plan can cost the HMO an additional $1 to $2.25 per member per month with a $10 patient co-pay, says Buron.
For more aggressive coverage (20 to 50 visits per month of acupuncture or chiropractic), the health plan's cost increases to $2.50 to $5.50 per member/per month, says Monica Wiley, corporate relations manager for American Specialty Health Plans (ASHP), a San Diego-based provider of direct-access chiropractic and acupuncture benefits.
ASHP is California's first chiropractic HMO providing chiropractic benefit plans to 17 traditional HMOs, including Kaiser Permanente, HealthNet, Prudential and Pacificare.
The Communication Void
Although consumer demand is high for alternative healthcare, consumers have limited knowledge of the full range of preventive benefits alternative care offers. Health plans have an opportunity, then, to educate members on what conditions chiropractic care, acupuncture and massage therapy are best used to treat, says Buron.
The best communication vehicles include:
- Employer-based health fairs and seminars, especially during open enrollment;
- Health plan and employee newsletters; and
- Employee-targeted health plan brochures and other marketing materials that accompany provider directories.
Educating your member physicians is also important. They need to be well-informed on how alternative healthcare is integrated in the health plan's benefits and should be given up-to-date research on its medical benefits and patient outcomes.
Although physicians are starting to change their tune where alternative healthcare is concerned, they still need to be reassured that the health plan is working with credentialed alternative providers and that the services have medical merit.
(Landmark, Kevin Buron, 916/569-3326; ASHP, Monica Wiley, 619/686-5990; Stanford University Medical Center, M.A. Malone, 650/723-6912)
Alternative Care Outlook
Consumers who are choosing a health plan view alternative healthcare options as a key factor, according to a study done by Landmark, a Sacramento, Calif.-based managed alternative care company. The study surveyed 1,500 adults nationwide.
When asked the importance of alternative healthcare benefits when choosing a health plan:
- 36% said they believe alternative care is somewhat important;
- 31% said it is very important; and
- 33% said it is not important.
When asked how they use alternative care with traditional care:
- 74% use alternative therapies with traditional care;
- 15% use it as a replacement for traditional care; and
- 11% use it along with and as a replacement for traditional care.
Source: Landmark
Alternative Care Attitudes
Last month, American Specialty Health Plans (ASHP), California's first chiropractic HMO, based in San Diego, commissioned a study to gauge consumer attitudes toward alternative care.
The study involved 1,000 adults nationwide. When asked what services come to mind when they think of complementary and alternative medicine, the responses include:
- Acupuncture: 28%
- Herbal medicine: 23%
- Chiropractic: 18%
Source: ASHP