More Payer Non Sense from our "Beloved Friend" United Health Care

While we're on the topic of criticizing the recent non sense from Blue Cross in California, I couldn't resist the opportunity to comment on UHC's recent change in payment policy declaring that they will no longer pay for any traction, cervical or lumbar, clinical or home (to take effect Jan 1). I can certainly appreciate that not all patients benefit from traction; however there is clearly mounting evidence for a subgroup of patients that benefit from this form of treatment (here, here, and here), particularly cervical traction. On the one hand, what's the big deal, right? You're only getting paid $35-50 now anyway, so what's another kick in the pants to you from UHC...we have grown to expect this type of non sense from them, never mind the extreme disservice this does to their customers, largely employers who should leave them in mass.

Please forgive my bluntness and direct tone, but this is the type of payer non sense that drives me nuts, primarily restricting the use of beneficial interventions amongst the very group of providers (physical therapists) who offer the most hope for solving the health care crisis in the MSK arena.  Let's presume for a moment that traction is completely useless for all patients (which it is not). But even if it is, this is an intervention used primarily in more chronic patients with radiculopathy, a group that is far more at risk to consume downstream health care costs if not managed effectively with less expensive non surgical interventions. Why in the world would you take away even a remotely beneficial intervention (and again, there is mounting very good data to support the benefits of traction for a subgroup of patients with spinal disorders, particularly cervical) that is non invasive, less expensive, and may curtail downstream health care costs!!!???

I am assuming UHC is going to hide behind the “there is no double blinded RCT mantra for traction” in defending this (I could write the defense I have seen it so many times). If my assumption is correct, then when is UHC going to come up with a similar policy that no longer pays for spinal fusion surgery or practically any of the other more expensive, less effective, highly invasive, and far riskier medical procedures that are done in droves...the real problem that plagues our health care system? All of this is a collective punch in the heart to those who offer the best solutions to real, meaningful, and lasting health care reform and is another example that things will continue to get worse before they get better.

Happy Holidays, UHC.

John