Alternative Healthcare Options / Wellspring

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    RALEIGH NEWS AND OBSERVER
    December 11, 1999
    Staff writer Alan Wolf

CLIENTS ATTRACTED TO HEALTH PLANS
OFFERING ALTERNATIVE HEALTH CARE COVERAGE

Starting Jan. 1, about 700 Triangle-area employees with Wellspring Grocery will switch their health coverage to Blue Cross and Blue Shield. Wellspring, owned by Whole Foods Market, a national chain of natural-food stores, made the move partly because Blue Cross recently began offering discounts on services like acupuncture and massage therapy.

Discount programs for so-called alternative therapies and products are starting to catch on as Blue Cross and other insurers rush to tap growing consumer demand.

"Our employees want alternative coverage; it's one of the things we hear every year," said Mary Miller, a Wellspring spokeswoman. "We've been jealous of our stores in California. They've always had more access to alternative medicine. It's encouraging to see it come this way." This week, Generations Family Health Plan, the HMO owned by WakeMed and UNC, said it will add a discount program. Partners National Health Plans is starting one in January, and UnitedHealthcare is considering ways to incorporate alternative benefits.

For HMOs, the programs are a safe bet because they're cheap to run and provide big marketing benefits. In turn, the discounts encourage more consumers to consider alternative treatments and provide a boost for acupuncturists and other practitioners.

"Things have changed pretty significantly in the past five years in terms of looking at acupuncture as a treatment option, first with patients, then doctors," said Dr. Scott Sanitate, an acupuncturist with the Carolina Back Institute in Cary. "Acceptance by insurers is really the last piece."

The programs generally give discounts of up to 25 percent off acupuncture, massage therapy, fitness centers, vitamins, nutrition counseling and other services and products.

For consumers, the discounts can add up. An acupuncture visit can cost anywhere from $60 to more than $100, with the initial consultation at the high end of the range.

Not everyone is convinced that the discount programs are needed. At Cigna Healthcare/Healthsource, "We have considered it but have not seen a great demand for such a program from our customers," said Steve White, head of the company's North Carolina operations.

Blue Cross wasn't the first insurer in this area to offer an alternative medicine program. WellPath Community Health Plans, the HMO owned by Duke University, started a discount program last year.

As the state's largest insurer, however, Blue Cross is a trendsetter. Plus, Blue Cross ran a massive television and radio advertising blitz around its Alt Med Blue program this fall, fueling interest for alternative medicine in general.

"There's a lot of flattery going on out there because there are a lot of people following our lead," said Blue Cross President Bob Greczyn. Blue Cross says its program is a huge hit, with a lot of positive feedback from members and nearly 4,000 calls to its information line since it was started in August. The Alt Med Blue Web site is one of the company's most popular.

"It's getting people in the door that wouldn't normally come in," said Lucian Larkin, a massage therapist with the Carolina Therapeutic Massage Center in Raleigh. "They don't want to pay the full shot. Money is a powerful motivator."

Americans spent about $27 billion out of pocket for alternative medicine in 1997, and the total is expected to climb to $34 billion next year, according to a recent study published in the Journal of the American Medical Association. The 629 million visits to alternative practitioners in 1997 exceeded the number of visits to primary-care medical doctors, the study said.

Some traditional doctors, however, caution that many alternative therapies are unproven and may be ineffective and even dangerous. Also, most insurers offer only discounts on alternative treatments rather than full coverage, so consumers still may face hefty bills.

"I'm not sure it's a wise way to go," said Dr. Robert Bilbro, a physician with Raleigh Medical Group. "Some of these alternatives will probably turn out to work, but we should get some evidence before people spend billions of dollars."

Under most of the discount programs, the practitioners cover the discount and members pay them directly, rather than the bills going through the insurance company. Avoiding the headaches of filling out paperwork to be reimbursed by insurance companies help make up for having to honor the discount, some practitioners say.

"Unfortunately, I don't get 25 percent off my bills or my rent," said Michael Alexander, who runs Alexander Acupuncture and Chinese Herbal Medicine, with offices in Durham and Raleigh. "But if more people come in, it might justify itself."

The discount programs cost the HMOs very little. The companies pay outside firms a small fee to set up a network of practitioners and run the programs.

"It's an easy thing to put in place, and you can get a lot of mileage out of it," said John McDonnell, a principal with Progressive Benefit Solutions in Raleigh, an employee benefits consulting firm. "This is just one more piece to set you apart" in the area's competitive health-care market.

Blue Cross uses California-based Consensus Health for its network of alternative health-care practitioners. WellPath and Generations use Alternative Healthcare Options, a Charlotte-based company.

"People want more choices, but they're also wanting more natural choices," said Richard Dunn, who founded AHO last year. "They want more options besides Prozac and surgery. The HMOs, they're answering that call from their members."

For Cyndy Fettig of Cary, who teaches English as a second language at Glenwood Elementary School in Chapel Hill, the ability to choose an alternative treatment is essential. Fettig, 33, has been going to a massage therapist for a year, ever since she was hit in the jaw by a soccer ball, and traditional treatments and painkillers didn't work. The problem was that Kaiser Foundation Health Plan, her previous HMO, didn't cover the visits. So she joined Blue Cross in October.

"It's one of the main reasons I switched over," Fettig said. "It's really a progressive program. It lets me make my own decision about what type of treatment is best for me."

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