Most people agree massage offers some therapeutic benefits, such as reduction of muscle tension and pain related to soft tissue strains and injuries. Studies have also shown it’s helpful in treating symptoms related to anxiety, digestive disorders, headaches and several other conditions.

It wasn’t that long ago that paramedical practitioners represented about 15 to 20 per cent of extended health plan costs. Now, it isn’t unusual for these costs to exceed drug costs and, under most plans, massage is the highest used paramedical service and represents the fastest growing cost.

Read: B.C. nurses’ massage benefits costs up $28M since 2008

If employees and their dependants were only using massage therapy benefits for bonafide medical issues, Canadian employers wouldn’t likely be facing the ballooning costs they are today. This is a problem largely unique to Canadian employers because it isn’t common for the benefit to be included in other countries’ employer-sponsored plans. This includes the U.S., where it’s generally only covered when medically necessary, if at all.

Massage isn’t like other paramedical benefits. People get massages even when there’s no underlying medical reason because it’s relaxing and feels good. No one is going to the physiotherapist or chiropractor unless they’re experiencing some sort of physical pain or discomfort, nor are they getting these types of treatment in an airport or shopping mall where it’s not uncommon to find a massage therapist.

Read: Massage use by Canadians on the rise, report finds

So far, most employers have been reluctant to reduce their massage therapy coverage because it’s highly valued by many employees. But employers looking for cost management options should consider the following plan design changes:

  • Cost sharing. Massage therapy is often covered at up to 100 per cent co-insurance to a maximum of $500 per covered family member per year. So where’s the incentive for employees to use this benefit wisely? Reducing the co-insurance or implementing a per visit maximum will provide immediate cost relief and may also encourage plan members to reconsider whether the treatment is necessary.
  • Limit who gets coverage. Some organizations regard massage therapy as more of a perk. If this is the case, plan sponsors should consider limiting coverage to employees only and exclude it for dependants.
  • Education. Many plan members have a misconception that the insurance company incurs the cost of claims. Once they understand their employer is essentially paying the full cost of claims, and that there could be future consequences if costs aren’t kept in check, employees may think twice before incurring an unnecessary expense.
  • Alternative therapies. Numerous people use massage to reduce stress and tension. Arguably, a daily practice of mindfulness meditation, yoga, breathing techniques and other relaxation methods can be equally, if not more, effective at long-term stress reduction and can cost very little, if anything.

Read: Dubious chiropractic claims show need for more scrutiny on paramedical expenses

Should employers consider requiring a doctor’s note for a massage claim to be eligible? Doctor’s notes aren’t the best way to help contain costs because they create a needless burden on the public health-care system already struggling to handle more urgent issues. As well, most doctors are willing to provide a note with little, if any, evidence supporting a specific medical need for a massage treatment.

While many employees use massage therapy for a genuine need, if too many people are taking advantage of it, plan sponsors may need to reduce or eliminate coverage, which could result in a financial hardship for those who actually need it.