CareFirst BlueCross Blue- Shield will begin offering a discount plan for alternative therapies to members next year that will not require them to get referrals from primary care doctors, the company said yesterday.
Starting Jan. 1, members of FreeState Health Plan, CapitalCare HMO, Delmarva Health Plan, and the Preferred Health Network will receive 25 percent discounts on acupuncture, massage therapy and chiropractic services from a group of more than 400 practitioners, said Dr. Eric R. Baugh, senior vice president for medical affairs and network management.
Baugh said CareFirst is the first health insurance company in the mid-Atlantic region to offer a discount program with a certified group of providers.
Members will also receive 15 percent discounts with selected personal trainers, fitness centers and day spas.
In June, yoga classes will be discounted through the program.
"It makes good sense, and our members want it," Baugh said. "It can complement the health care provided by our physicians."
Though CareFirst will not require members to get referrals or fill out paperwork to get discounts on alternative therapies, it does recommend that patients discuss the treatments with their doctors, said Baugh, a board-certified family practitioner.
Company research found that nearly 40 percent of its members already use alternative therapies, he said.
He also noted a study recently published in the Journal of the American Medical Association that shows the number of people visiting alternative-medicine providers increased 47 percent between 1990 and 1997.
The same study found 42 per- cent of adults used at least one form of alternative therapy in 1997, spending more than $33 billion, Baugh said.
While CareFirst is not directly cashing in on the popularity of alternative therapies, the company does hope the program will have positive marketing ramifications, said Debbie Rosen McKerrow, manager of media relations.
"This is something that we offer and other [providers] don't. So we hope it is something that people will look at when they choose their health plans."
Sharon Sopp, spokeswoman for the Center for Health Enhancement at St. Joseph Medical Center in Towson, which offers acupuncture, massage therapy and other holistic treatments, said offering such a program could save a health provider money, too.
"It's cost effective. If you get someone to manage their stress levels, there is a better chance their blood pressure or other ailments won't give them a lot of problems," she said.
Baugh said he visits a massage therapist once a month and believes that alternative methods do have positive health benefits.
"There has been good clinical data that shows that this not only promotes health but maintains health," he said. "We want to promote healthy lifestyles and these are healthy lifestyles."
The new discount plan, CareFirst Options, will be developed in conjunction with Consensus Health of Emeryville, Calif., which will provide credentialing and contracting with the practitioners, plus operate a member call center.
Before credentialing a provider, Consensus Health looks at a practitioner's experience, training, licenses and malpractice insurance as well as the provider's offices, said Brenna Harrington, a company representative.
Consensus Health also inspects health clubs and spas before certifying them.
Walter Cherniak, spokesman for Aetna U.S. Healthcare, said Aetna's Natural Alternatives program also offers discounts on acupuncture, massage therapy and chiropractic service. But, Cherniak said, Aetna does not "do the kind of thorough credentialing that we do with our network providers."
Pub Date: 9/22/99