Editorial: Massage issue reflects tough choices for plan sponsors

Despite all of the concern about the sustainability of drug plans, it seems rising claims for paramedical services such as massage therapy aren’t a big issue for many plan sponsors.

This month’s cover story, “Unknotting the goals of massage therapy as an employee benefit,” delved into the question of what coverage should be about. Is it only for medically necessary services when a plan member has a physical illness or injury? Is it worthwhile to cover massage in order to relieve employee stress? Or is it a perk employees have come to expect?

As Sara Tatelman found in her interviews for the story, many people, including plan sponsors, don’t see a big issue around massage claims. It can be helpful in promoting employee wellness and, potentially, preventing future issues that can cause absences and other types of benefits claims, they say. And with the costs of paramedical claims far below those associated with drugs, what’s wrong with giving employees something they like?

Read: Unknotting the goals of massage therapy as an employee benefit

There’s nothing wrong at all, although it would be better if plan sponsors were approaching the issue fully aware of why they support massage benefits. Is there enough evidence to show massage really does relieve stress and promote employee well-being? Does it really prevent other types of claims? And even if it doesn’t, does the plan sponsor have a philosophy underlying its benefits plan that otherwise justifies the expense of funding massage therapy at a particular level?

The challenge is that at a time of rising costs for new drugs (see Tatelman’s other story in this month’s issue, “A look at three diseases plan sponsors should be aware of”), plan sponsors will likely have to start making choices about what they can cover. The pressures will come from several areas, including diseases such as cancer for which new treatments are helping to shift added costs onto private payers from the public health system.

Read: A look at three diseases plan sponsors should be aware of

There’s nothing wrong with opting for generous coverage of massage therapy, but it would be better if plan sponsors were doing more to actively consider that choice in light of the evidence of its effectiveness and the other pressures their plans are under.

As Tatelman found in looking into the massage issue, it seems few plan sponsors are making reductions to massage coverage. They may have good reasons for not doing that, of course. They may have decided maintaining massage benefits is a good way to keep employees happy and engaged or they may have found it’s truly helpful to their staff.

But if the reason is simply that they haven’t considered the issue or are leery of making any changes employees won’t like, they may be pushing a looming concern into the future. And that’s not good enough. As questions grow about the sustainability of benefits plans, employers need to be considering the tough choices or, at the very least, be making decisions about coverage more consciously.

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