Health plans should review their benefit packages to ensure they include nonpharmacological approaches to pain management, such as acupuncture, physical therapy, counseling, or hypnosis. It is important that members have access to these treatment options without copayments or other provisions (e.g., authorization requirements) that may discourage their use. In this section we include examples of health plans offering nonpharmacological benefits for pain.
How to Do It
- Review benefits for comprehensive approaches to chronic pain management.
- Identify and remove obstacles or disincentives (e.g., remove copays and authorization requirements for physical therapy).
- Educate the provider network and work with it to ensure that members access benefits.
Health Plan Stories
Central California Alliance for Health
Inland Empire Health Plan
Oregon-based Samaritan Health announced in 2016 it would remove prior authorization requirements and session limits for patients seeking physical therapy to treat pain. The change was in response to emerging evidence showing movement therapy and exercise could improve back pain. Prior to this, Oregon Medicaid altered its Medicaid plan to allow beneficiaries to access physical therapy and other nonsurgical and nonpharmacologic approaches to back pain as the priority treatment.
- America’s Health Insurance Plans: STOP Playbook: How Health Plans Are Tackling the Opioid Crisis (PDF)
- Aetna News: “Aetna Announces New Policies to Improve Access to Narcan, Combat Overprescribing“
- California Health Care Foundation: “Changing the Approach to Pain Treatment” (video)
- California Society of Addiction Medicine
- Camden Coalition