ALTERNATIVE MEDICINE: OXFORD HEALTH TO CREATE NETWORK
Oxford Health Plans Inc. is expected to announce tomorrow anThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
alternative therapy provider network. WALL STREET JOURNAL
reports that Oxford's move will give "alternative health
treatments such as acupuncture and massage therapy ... an
enormous boost." Norwalk, CT-based Oxford, "one of the nation's
largest and most influential managed care plans," intends to
establish a network of 1,000 holistic providers "to mirror its
existing network of 33,000 traditional doctors" (Lagnado, 10/7).
The Oxford program will "fully cover chiropractic, acupuncture
and naturopathic treatments from a network of prescreened
providers for an additional premium cost of two percent to three
percent." Members will be able to purchase yoga, massage and
nutrition services at a discounted price from Oxford, as well as
mail order discounted herbal remedies, vitamins and other
supplements (AP/Baltimore SUN, 10/7). Patients will not need
prior approval from a gatekeeper physician to visit a
naturopathic provider. The services will be available starting
in January in New York, Connecticut and New Jersey (JOURNAL,
TREND-SETTING?: JOURNAL reports that Oxford's move "marks
one of the most aggressive yet in embracing alternative
therapies, and it is raising hackles in more traditional quarters
of the medical industry." But whether Oxford will successfully
tap the $50 billion alternative therapy market that has become
"increasingly popular" with consumers, "remains a source of deep
controversy," according to the JOURNAL. While some large health
plans such as California-based Kaiser Permanente have "embraced"
alternative therapies, and Prudential Insurance Co. of America
offers limited coverage for acupuncture and other alternative
treatments, "most have drawn the line at developing a formal
provider network." JOURNAL notes that "Oxford's venture ...
suggests that HMOs are eyeing alternative medicine as a potential
CONTROVERSIAL MOVE: Barry Scheur, a Boston HMO consultant,
said that while Oxford has "clearly 'seized an excellent market,
it is bound to be controversial.'" Dr. Nancy Dickey, chair of
the American Medical Association (AMA), questioned Oxford's
motive, saying "Is this what (consumers) want or is it to save
money?" JOURNAL reports that the AMA "and other bastions of
conventional medicine worry about an invasion of dubious
practitioners with unproven claims" who might send a patient to
an alternative care provider which could "prove to be far
cheaper" than a referral to a conventional physician. Dickey,
after "conceding" that a growing number of consumers are choosing
alternative medicine, said "she hoped Oxford and HMOs ... would
make sure to have 'admonitions in place to assure patients are
not directed or encouraged to use alternative providers in place
of known treatments."
CONSUMER PREFERENCE?: Stephen Wiggins, chair and chief
executive of Oxford, said the decision to offer alterative
therapy options "came in response to a pent-up demand among
consumers." He said, "This is less an insight of Oxford than a
recognition of the obvious trend: the demand by consumers to
seek an alternative to conventional Western medical solutions.
You ignore the consumer at your own peril."
THE BOTTOM LINE: JOURNAL reports that "there is little
doubt that alternative medicine is traditionally less expensive
than conventional medicine, and one question that arises is
whether bottom-line conscious HMOs will seek to direct patients
toward alternative treatments as a way to reduce costs" (10/7).
Randall Huyser, an HMO industry analyst with Furman Selz in San
Francisco, said, "Quite often these things can be less expensive
than traditional health care, especially if you can avoid
hospitalizations." He added that "there is a tendency for people
that like holistic cures to be generally healthier people, so
they are more attractive patients for HMOs" (AP/SUN, 10/7).