Concomitantly, many health benefit carriers are providing coverage or discount programs for their members who choose certain CAM treatments.
“With CAM discount programs, employers and consumers can save on a variety of alternative approaches to preventive care and the maintenance of good health, from chiropractic services to vitamins, nutritional and herbal supplements, and related products,” says Heather Dowell, manager of sales and service, covering Illinois and Wisconsin.
Smart Business spoke with Dowell to learn more about complementary and alternative medicine and how it is being incorporated into health benefit plans.
What is complementary and alternative medicine?
The industry defines CAM as a group of diverse medical and health care systems, practices and products that are not presently considered to be part of conventional medicine. While scientific evidence exists regarding the safety and effectiveness of some CAM therapies, for most therapies these key questions still need to be answered through well-designed scientific studies.
As CAM therapies are proven to be safe and effective, they are often adopted into the conventional health care system. Since information on CAM is changing constantly, patients should talk with their doctors before using any CAM therapy.
Do complementary medicine and alternative medicine differ from each other?
Yes. Complementary medicine is used with conventional medicine. For example, aromatherapy is used to lessen a patient’s discomfort following surgery.
Alternative medicine is used in place of conventional medicine, such as using a special diet to treat a diagnosed cancer, rather than having the patient undergo doctor-recommended surgery, radiation or chemotherapy. Any time complementary or alternative medicine is being considered, it’s vital to research the effectiveness of the therapy.
What is the employer perspective on CAM?
Employers are showing increasing interest in CAM and looking for value-added CAM programs offered by health benefit carriers. And they are concerned that patients have accurate information regarding CAM therapies.
There is a significant amount of advertising and promotion of CAM products in the marketplace. This information shouldn’t be confused as an objective account of scientific research.
One good place to find information about CAM therapies is the Web site www.Intelihealth.com, which features Harvard Medical School’s consumer health information. We also encourage members to speak with their doctors about any CAM therapies they may be using, because the therapies could cause dangerous interactions with other medicines.
How should individuals find a doctor who understands CAM?
Finding doctors who understand CAM is becoming easier. Many doctors have grown more receptive to the potential benefits of CAM treatments.
But, individuals should research basic information about the doctor first, including location, gender, medical school, year of graduation, residency training, board certification, and specialty and hospital affiliation.
Then learn about other health care professionals who are affiliated with that doctor. Many health carriers maintain online provider directories that contain much of this information.
Next, individuals should ask the doctor directly about the type of practice and the doctor’s attitude toward complementary and alternative medicine.
Does the doctor give you the balanced advice you are seeking? You may have to pay for a couple appointments before you find the right doctor to guide you through the maze of complementary and alternative therapies. Whatever your goals, you will benefit most from a doctor who neither condemns complementary and alternative medicine wholesale nor blindly advocates it
Does the insurance industry make CAM services available?
This varies by carrier and is subject to benefit plan designs. Frequently, discounts will be offered if a patient uses a provider that participates in a carrier’s health plan. Examples of CAM services available at a discount include acupuncture, nutritional counseling and chiropractic services.
Other carriers provide discounts for over-the-counter vitamins and nutritional supplements purchased through contracted vendors. Again, before individuals purchase a discounted service or product, we recommend that they ask their physician if the service or product is right for them.
Who is eligible to participate in CAM programs offered by carriers, and how much do the programs cost?
This varies, depending on the carrier. Experience suggests that many carriers do not charge additional fees or premiums to employers or employees for access to their CAM discount programs. Generally, the employee only has to pay the discounted cost of the CAM service or product.
Heather Dowell is manager of sales and service, covering Illinois and Wisconsin. She is responsible for managing sales and client management for Aetna’s select accounts segment, which includes businesses with 51 to 300 employees. Reach her at (312) 928-3585 or DowellH@aetna.com.