Complementary and alternative medicine in multiple sclerosis: Payment policy perspectives.

Area of Science:

• Neurology
• Healthcare Policy
• Complementary and Alternative Medicine

Background:

• The American Academy of Neurology (AAN) provides guidelines on complementary and alternative medicine (CAM) for multiple sclerosis (MS).
• These guidelines serve as a resource for recommending or not recommending specific CAM treatments.
• Current healthcare payment policies often do not cover CAM therapies, regardless of their categorised effectiveness.

Purpose of the Study:

• To identify the payment policy perspectives related to the AAN's guideline on CAM in MS.
• To explore how neurologists can better integrate patient counseling and care coordination for CAM within existing healthcare structures.
• To highlight the disconnect between guideline recommendations and payer coverage decisions for CAM therapies.

Main Methods:

• Analysis of the AAN's guideline on CAM in MS.
• Review of payment policy implications for CAM treatments.
• Consideration of strategies for enhancing patient counseling and care coordination.

Main Results:

• The AAN guideline categorizes the probable effectiveness of CAM therapies but does not influence payer coverage decisions.
• Payers generally do not cover CAM therapies, irrespective of their potential benefits.
• Neurologists are encouraged to utilize advanced practice providers and visual aids for patient counseling and rely on evaluation and management codes that recognize time spent on counseling and care coordination.

Conclusions:

• The AAN guideline on CAM in MS is a valuable resource, but its recommendations on effectiveness do not translate into insurance coverage.
• Neurologists need to adopt strategies to effectively counsel patients on CAM and coordinate care, potentially leveraging advanced practice providers and appropriate billing codes.
• There is a significant gap between clinical recommendations for CAM in MS and actual healthcare payer policies, limiting patient access to these therapies.