managed//1stdp/mark2nd

By JESSICA TOLEDANO

Staff Reporter

Don't expect your managed care provider to start covering kava for stress or garlic pills for your digestive system. Health care companies have been slow to jump on the holistic bandwagon citing the lack of hard scientific data and regulation.

Some forms of alternative medicine, however, are being covered a striking contrast to just five years ago when many in the industry scoffed at herbal remedies or therapeutic massages.

Today, Kaiser Permanente offers chiropractic services. Blue Shield of California covers acupuncture. Health Net is applying for a state license to offer acupuncture and herbal medicine.

Why the abrupt change in attitude? Simple demand.

"Consumers are spending unprecedented dollars on alternative modes of care," said Bob Wadsworth, manager of commercial products for Blue Shield of California based in San Francisco. "What we want to do is understand what our customers want and deliver what they want cost-effectively. But we still have the challenge of weighing what our customers want with what is clinically responsible."

Alan Kittner, chief executive of Consensus Health Corp., which negotiates contracts for more than 650 alternative medicine practitioners in L.A. County, said the number of people who use providers he represents went from zero in 1996 to 2 million by the end of 1998.

"It is an incremental process for managed care companies," said Kittner. "There has to be a lot more clinical and financial evidence that it is beneficial. It will never be blanket coverage of alternative methods, but condition by condition the companies will start to cover more remedies."

Those remedies are not likely to include ginkgo, ginseng or vitamin C at least not anytime soon.

"Until we can get scientific-based studies to show alternative methods can be effective, we have to be circumspect in our acceptance," said Dr. Leon Cohen, physician director of network quality for Kaiser Permanente.

The big question, said Kittner, whose company contracts exclusively with Blue Shield, is "if you utilize (alternative) care alongside traditional, does it cost more or less? They want to make sure they are not just adding services that cost more money."

Some consumer advocates are up in arms over health care companies offering alternative care at a time when some traditional medical treatments are denied.

"One has to question why health maintenance organizations are allowing members to get massages, but not allowing them to go to the best cancer centers for treatment," said Jamie Court, director of Consumers for Quality Care in Santa Monica. "I don't have a problem with them covering alternative medicine, but then they can't cry poverty when it comes to traditional medicine."

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