With employers already facing enough cost pressures around their benefits plans, adding additional coverage for paramedical services may be a daunting prospect. But with employees often looking for coverage for a broader range of services, is athletic therapy worth considering?
The Canadian Athletic Therapists Association, in fact, helpfully provides employees with a sample letter on its website that they can submit to their employers to advocate for coverage. “Athletic therapy treatments are based on the scientifically supported sport medicine model, an active approach to rehabilitation that focuses on finding and treating the cause of conditions not just the symptoms, as well as the patient taking an active approach to rehabilitating their injury versus a passive, therapist-dependent approach or reliance on modalities,” the letter states.
“This improves the efficiency of treatments, which can benefit in faster recovery, faster return to work, fewer disability claims and decreased chance of re-injury.”
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Not everyone sees it that way, however. The issue of covering athletic therapy arose in a recent arbitration involving a collective agreement for Toronto firefighters. Although the ruling extended paramedical benefits to include athletic therapy, the employer nominee on the arbitration panel disagreed and indicated that only two of the 80 full-time firefighter departments in Ontario permitted athletic therapy coverage. “There is no reason to expand the scope of this based on the comparables — it is a breakthrough benefit. No evidence was submitted to show any demonstrated need for this type of service,” wrote John Saunders, the city’s nominee on the arbitration panel.
Erin MacLean, a certified athletic therapist at the Elliott Sports Medicine Clinic in Burlington, Ont., says most clients at her clinic wouldn’t be able to see the difference between physiotherapy and athletic therapy. Physiotherapy, she notes, is more manual-based. “We do manual therapy as well but we not only treat the symptoms; we also try to figure out why it happened and try to prevent it from happening again.”
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But some consultants aren’t buying it. Yafa Sakkejha, general manager of Beneplan Inc., says employers shouldn’t cover athletic therapy. “Why would they? Why would they spend money on another category of practitioners who are trying to bill the insurance system as much as possible, when they’re actually billing the system of businesses and small-business owners who pay the bill,” she says.
Sakkejha feels employees exploit paramedical benefits. “Most of the time they’re legitimate, but many, many times it’s illegitimate,” she says. “We have a huge problem of plan members saying, ‘Hey, I’ve got this money and I should use it for something.’ It’s so difficult to see who is genuine and who is not.”
Another negative is the inevitable cost of extending coverage, which will have an impact on pricing when an employer renews its benefits contract. Still, Shane Hohlweg, a principal and benefits consultant at TRG Group Benefits & Pensions Inc., can see the merits.
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“The merits of having [athletic therapy] as an employer — especially if you’re in a labour-intensive type of industry — is that you’re giving the opportunity for your employees to be more proactive in their health management versus reactive,” he says.
Although Hohlweg doesn’t have many employers “banging on the door” to demand athletic therapy, there are a few that have raised the issue. “Employees are going to their HR manager inquiring why athletic therapy is not included as part of the core package of their paramedical practice.”
MacLean has seen employers offering athletic therapy as a separate line item on their paramedical roster or as an alternative to physiotherapy. Employers can even restructure their benefits plan design to add in a health-care spending account, says Hohlweg. “If your plan design is $250 per practitioner, you could offer $250 under an HCSA and align it so that it’s typically only [used] for athletic therapy.”
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