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Massage Today
February, 2001, Vol. 01, Issue 02

When Massage Meets Managed Care

Rising Inclusion in Health Care Plans Should Spark Debate

By Peter W. Crownfield

The issue of unity vs. separatism is not new to our nation's history, just well-traveled. The most notable example is the Civil War, fueled by the South's desire for economic and political separatism from the Union.

A century-and-a-half later, the issue of unity vs.

separatism is still sparking national controversy, and once again, economic and political factors are involved. This time, it is not North vs. South, but massage therapy vs. managed care.

What follows are a few examples of recent agreements between managed care organizations and provider networks. These contracts already impact the practice activities of thousands of massage therapists - and the trend is almost certain to continue, involving even greater numbers of the massage community. (Editor's note: For a more specific discussion on the pros and cons of the debate, read this month's article from the editor's desk: www.massagetoday.com/archives/2001/02/06.html).


Complementary Healthcare Plans recently contracted with HealthNet Oregon, to provide its members with access to credentialed provider networks of alternative care providers, including massage therapists. Coverage under prepaid plans allows for self-referral and direct access to practitioners.

A preferred provider organization (PPO) in Portland, Oregon, Complementary Healthcare Plans provides health care services to 333,000 prepaid members and nearly 600,000 others under contract with managed care organization (MCO) and PPO plans.


Effective January 1, 2001, Blue Cross/Blue Shield Service Benefit Plan members have access to a national network of massage therapists, chiropractors, acupuncturists, and health and wellness products at discounted prices.

The program was instituted as part of an agreement with American Specialty Health Networks (ASHN), a San Diego, California-based organization. Members will receive discounts of up to 25 percent on visits to ASHN's credentialed network of providers and can make appointments directly without physician referral.

Members will also have access to various internet resources, including national online provider directories, educational information on complementary and alternative medicine, and discounted health and wellness products. The Blue Cross/Blue Shield Service Benefit Plan currently covers approximately four million federal employees, retirees and their family members.


ASHN has also contracted with HomeTown Health Network to provide alternative and complementary medicine services to HomeTown's 65,000 members throughout the state of Ohio. HomeTown members can access a credentialed network of massage therapists, chiropractors and acupuncturists.

These services are provided without gatekeepers and with discounts of up to 25 percent.

Additionally, an ASHN affiliate, Healthyroads.com, is providing internet-based services for HomeTown members, including a directory of the network's providers, educational resources, and discounted health and wellness products.


BlueCare Network, the HMO affiliate of Blue Cross/Blue Shield of Michigan, has launched a program called "Naturally Blue" that provides 20 percent discounts for massage therapy, acupuncture and nutritional counseling services. The agreement is with Landmark Healthcare, Inc., a Sacramento, California-based company.

Under terms of the agreement, Blue Care Network members can receive discounted services from any practitioner in Landmark's statewide practitioner network, simply by presenting their identification card.

  • BlueCare Network currently serves 600,000 members throughout Michigan.
  • PacifiCare of Colorado has been offering 10-15% discounts on services  since late last year.
  • Aetna U.S. Healthcare has had its program in place since 1999, serving all  its Colorado members.
  • Cigna Healthcare, with 14 million members nationwide, instituted a program  in November 2000 that provides for discounts of up to 25 percent off standard rates for massage therapy, acupuncture and chiropractic care. Cigna's discounted services require no gatekeeper involvement.
  • Anthem Blue Cross Blue Shield is now considering providing similar discounted services to its Colorado members.

The extent to which the inclusion of massage therapy in the managed care world will affect the profession remains to be seen. One thing is certain: the issue will generate substantial debate among the massage therapy community. Look for further information in future issues of Massage Today.

 

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