{"id":220,"date":"2020-02-26T16:10:49","date_gmt":"2020-02-26T16:10:49","guid":{"rendered":"https:\/\/penmore.com\/insurance\/managing-paramedical-benefits\/"},"modified":"2022-09-15T14:16:02","modified_gmt":"2022-09-15T14:16:02","slug":"managing-paramedical-benefits","status":"publish","type":"post","link":"https:\/\/penmore.com\/insurance\/managing-paramedical-benefits\/","title":{"rendered":"Managing Paramedical Benefits"},"content":{"rendered":"

Think about why<\/u> you offer paramedical benefits in order to manage them effectively<\/em><\/h3>\n

By Bill Zolis<\/p>\n

\u201cIf you build it, they will come.\u201d Okay, it\u2019s a line from a movie, but it applies to paramedical benefits, too, and that\u2019s what I want to talk about. If we offer a range of paramedical services as part of our benefits plans to employees \u2013 things like massage therapy, naturopathy, acupuncture, chiropractic services, and osteopathy \u2013 we should not be surprised or alarmed if people start using them.<\/p>\n

But it\u2019s not really about Field of Dreams<\/em>. There\u2019s a flip side to that movie quote: \u201cIf they come, someone will build it.\u201d That\u2019s where some of the concerns I\u2019ve heard from clients come in. Simply put, as most benefits plans provide coverage for paramedicals, more and more providers of those services are popping up \u2013 and even adapting their service offerings to be in line with benefits coverage.<\/p>\n

That\u2019s where the grey areas, the uncertainties and a lot of the grumbling come into the picture. Is such-and-so really a legitimate treatment? Is this service really indicated for that employee? Is it really going to make a difference? What about the employee who just maxes out his or her claims for every service every year? Or the paramedical provider who maxes out one item and then refers the employee to a colleague offering similar services under a different item?<\/p>\n

My advice would be to get comfortable with that, and manage it as the new reality, or we risk accomplishing the very opposite of what we had in mind when we brought in paramedical benefits in the first place.<\/p>\n

Okay, that may surprise you. Let me tell you why I\u2019m thinking this way.<\/p>\n

Essentially, employers offer paramedical benefits to employees for a number of very different reasons. I think if we break it down and look at those reasons individually, we can get a much better understanding of what we\u2019re trying to accomplish \u2013 and how to accomplish it successfully.<\/p>\n

1) The core purpose of offering paramedical benefits is to support the health and wellness of employees and their families, by providing treatment for conditions, or encouraging lifestyle changes that result in better health outcomes. This is pretty obvious, and it may be the only thing you read on the benefits brochure, but let\u2019s not think for a moment that it\u2019s the whole story.<\/p>\n

2) A second purpose is to provide support \u2013 and to be seen to be providing support — for employees struggling with health issues. There are any number of wellness issues, some black-and-white, some every shade of grey in between, for which employees seek help from paramedical providers when mainstream medicine isn\u2019t helping them. Maybe the condition is well defined and maybe it isn\u2019t. Maybe the treatment objectively helps and maybe it doesn\u2019t. But the point is that you, as employer and benefits provider, are providing support to that employee to work through a rough patch.<\/p>\n

3)\u00a0 And, third, let\u2019s not forget the fact that a big part of the reason you offer paramedical benefits in the first place is that you want to have a Cadillac benefits plan to attract and retain employees, and as part of your efforts to do everything possible to build \u201cthe well workplace.\u201d<\/p>\n

I think all three of these reasons carry almost equal weight. But it is not always communicated within the organization, and this is where a lot of the discomfort with paramedicals comes into play. Basically, the benefits administrator, looking at the numbers at the end of the year, says, \u201cI don\u2019t think that maxing out this service and then maxing out this other service are really helping that employee\u2019s bad back at all.\u201d And the CEO, if anyone asked him or her, replies, \u201cYeah, well it would be nice if it did help his back, and maybe it will, but we\u2019re also doing this to show that we care, that we\u2019re doing everything possible to support all our employees, and that we really mean it when we say we have the best benefits plan in the industry.\u201d<\/p>\n

It\u2019s tricky and hard to navigate. On the one hand, if we push back too hard on iffy claims or practices, we risk creating dissatisfaction among employees; on the other hand, if allow any kind of abuse of the system, the word spreads though the workplace in no time at all, and the result is even more dissatisfaction. Ironic, when you realize that half the reason we\u2019re doing this is to build employee satisfaction in the first place.<\/p>\n

So what should we do? When I said, \u201cget comfortable with it and manage the new reality,\u201d I was basically talking old-time religion:<\/p>\n