While a new collective agreement negotiated between the British Columbia Nurses’ Union and the Health Employers Association of B.C. won’t bring significant changes, the round of negotiations did raise an issue with paramedical benefits, specifically the amount spent on massages.
Currently, nurses in the province have unlimited dollars to spend on massages, which are 100 per cent paid for by the association.
According to a telephone town hall between the union and its members in December, the generous allowance has resulted in a huge increase in massage costs. Reports showed massage costs climbed to $31 million in 2018 from $3 million in 2008, according to Umar Sheikh, chief executive officer at the nurses’ union.
“This is an exponential increase in massage,” he said during the town hall. “This benefit is not being used by 80 per cent of our membership currently. And so what you’re seeing is a small amount of the membership taking a very large amount of that benefit envelope.”
According to Sheikh, the data showed one member racked up $174,000 of massages in a year. “That is 1.8 massages per day,” he said. “That is not common, of course, within our membership, but when you look at the top tier percentage using that massage, that is the type of data that you start looking at.”
In light of recent findings, the nurses’ union will undergo a year-long consultation with members about what benefits they prioritize and how it can change the paramedical benefits plan. For instance, it may introduce a reasonable cap on massages and reallocate the money towards other benefits used by more members or put the funds towards a health-care spending account, noted Sheikh.
While the union wants to help nurses access massage services for medical or preventative reasons, it also wants to ensure benefits are equitable and that employees get the most value from their plan, he said.
Indeed, some plan providers like Green Shield Canada are implementing stricter measures to curb massage spending. Massage is the most popular benefit among plan members — they spent four times more dollars on massage therapy than mental-health services in 2018, according to the insurer. As a result, it’s removing massage as a core benefit from its SMARTspend program, which will focus on other benefits such as vision care, digital mental-health support and health coaching.
“I think some of our most recent communications have focused heavily on massage therapy because questions there are longstanding, and there are real questions around efficacy and the outcomes being produced by massage therapy, not across the board, but to a large degree,” says Ned Pojskic, leader of pharmacy and health provider relations at Green Shield Canada.
Employers should look at the evidence to determine whether massage coverage brings value to the organization, noted Chris Bonnett, principal at H3 Consulting, in an email to Benefits Canada.
While the B.C. Nurses’ Union case may be be an outlier, the general increase in massage spending could reflect the new realities of today’s workforce, including more stress among employees and an aging workforce, said Bonnett. “If the workplace helps create stress, then it’s not surprising that massage use is increasing . . . . Massage can be for relaxation or it can be therapeutic, especially for older workforces. While some think massage is misused, others will believe massage has an impact on employee satisfaction, well-being and ultimately productivity.”
In light of these discussions, should plan sponsors be providing access to unlimited paramedical benefits? And is it worth conducting a regular review of benefits like massage coverage? Have your say in this week’s online poll here.
The previous poll looked at Ontario’s pilot project on social prescribing, asking whether it’s a good idea to incorporate social prescribing into workplace wellness programs. Almost three-quarters (73 per cent) of respondents said yes, social prescribing could benefit employees and employers, while just over a quarter (27 per cent) said no, their employer already had enough health and well-being benefits to juggle and social prescribing should be left to the government.