Non pharmacological pain management such as chiropractic is better and safer, so why do insurer’s want to make it cost more?
The HHS (Health and Human Services) task force found that insurers were not covering Non pharmacological pain management methods such as chiropractic or acupuncture. These methods are often more expensive than opioids and insurers have used this as a reason behind them favoring one type of treatment against the use of medication such as opioids. The HHS collected years of data which helped them arrive to the conclusion that insurers may have inadvertently caused the Opioid crisis with their policies. This policy long term has been much more costly and harmful to the public at large.
This was based off of a congressionally mandated report from the Pain Management Best Practices Inter-Agency Task Force on gaps in treatment concluded that payers often don’t pay for non pharmacological pain management that is more expensive than opioids in the short term.
America’s Health Insurance plans lobby group ignores the evidence.
Recently, insurers through their America’s Health Insurance plans lobby group pushed back stating that the evidence is hampered by incomplete data regarding these different modalities for problems such as back pain and that there is a lack of standardized licensing for methods such as Thai Chi and Yoga for instance.
The AHIP used the example of acupuncture for shoulder pain vs. the use for lower back pain. Apparently, they have failed to realize that shoulder problems and lower back problems are interrelated as one region affects the function of the other. Insurers are trying to make the case that people are not the sum of our parts, which actually is the problem.
Take a walk in the park and watch how people walk, and then see if you see a shoulder or a knee in the park walking. While this sounds ridiculous, insurers are telling us that treating parts is appropriate. Anyone who has had an unnecessary MRI or surgery may have chosen an alternative method if they knew more than their doctor in the white coat knew.
Insurance companies also need to be evidenced based.
The Annals of Internal Medicine report a few years ago mentioned many of these treatment methods that were preferable for back pain including manipulation, exercises, yoga, Thai Chi, and Acupuncture which should be used first, while medication and interventions such as injections should be used last. This was based on years of collected data. The problem is, the current position of AHIP is bad for healthcare, while a holistic approach to care, while more costly initially is less expensive in the long run when treating problems such as back pain.
Healthcare providers are becoming far more evidence based than insurance carriers, but the evidence supports non medicinal methods of pain management as an initial approach to pain. If insurer’s are concerned about the evidence, why are they ignoring it?
Back problems can be caused by the feet, the upper body, an old injury, body asymmetries as well as an acute injury for example. If these are the mechanical causes, how can you rely on studies alone to treat back pain, while ignoring the body. If you properly diagnose and treat the common element behind the back or shoulder pain, three or four other conditions such as knee, neck or hip problems may never develop. The common element in the Annals of Internal Medicine report is movement. All of these methods that are proven are movement based. Chiropractors use more of these methods in their practices than other practitioners which may be why the public likes their version of non opioid pain management. The problem is, insurers have made it expensive to use these highly effective healthcare providers. They have also put too many people on drugs, especially the elderly.
Apparently, the only company that seemed to understand this was United Healthcare’s Optum division. While they are not the best example, they have said that the data is conclusive, use chiropractors and other mechanical specialists for problems such as back pain.
Insurers are beholden to their shareholders, not you or your health concerns.
Insurers make money by keeping costs high, which allows them to justify price increases which increases the legal percentage they can collect and keep from your premium dollar. This is why most insurers are having record profits right now. The down side is, they can no longer control the costs as hospital systems have created monopolies in their regions of where they have facilities. This has been highly inflationary, especially as they purchase physician practices who are sending patients to hospital based services which are more expensive overall. The government has no clue as the politicians are paid to listen to the concerns the insurance lobby expresses to maintain the status quo.
If costs go down, so will your premiums and deductibles which is bad for their bottom line, but may force us into a single payor system or a choice to use and expand Medicare as our current system is in crisis. Isn’t it about time we stop listening to health insurers? Their method of incentivizing expensive and invasive procedures while minimizing primary care and portal of entry providers such as chiropractors is inflationary, and bad for your health.
Check out Modern Healthcare’s recent article on this.
Insurers push back on HHS recommendations for non-opioid treatment
by ROBERT KING April 02, 2019
Insurers pushed back against an HHS task force’s finding that they are not covering non-opioid pain management therapies such as acupuncture, while proponents of such treatment see a chance to argue for Medicare reimbursement.
A congressionally mandated report from the Pain Management Best Practices Inter-Agency Task Force on gaps in treatment concluded that payers often don’t pay for non-opioid therapies that are more expensive than opioids. But America’s Health Insurance Plans, the top insurance lobbying group, said in comments to the report that it isn’t that simple.
“There are many approaches to therapeutic modalities (e.g., acupuncture, yoga, tai chi),” AHIP’s comments said. “These pose unique challenges to building a network of providers due to the lack of standardized licensing.” AHIP added that there are limitations with existing evidence for some of the emerging therapies and “conflicting and difficult-to-follow treatment guidelines.”