Insurance companies are reimbursing for medical nutrition therapy.(Statistical Data Included)

The provision of comprehensive nutrition services is a cost-effective means to treat disease and prevent complications of illness, which results in health benefits to the general public [1]. Insurance industry mergers and lack of set reimbursement policies have adversely affected the ability to obtain insurance coverage for health services, especially for medical nutrition therapy (MNT) [2,3]. Attempts have been made to estimate how often reimbursement occurs for MNT [4-7].

To justify the benefits of MNT, The American Dietetic Association (ADA) has initiated outcome and cost-effectiveness studies. One study of cost savings for physician's office and hospital outpatient visits and for hospital admissions demonstrated a reduction in use of these services and costs as a result of MNT, and indicated that the initial cost of MNT would be exceeded by substantial savings in the long run [8]. Cost-effectiveness studies are important in ADA efforts to obtain inclusion of MNT in the Medicare Medical Nutrition Therapy Act. Since the 1960s, Medicare has been a role model for insurance companies, and inclusion of MNT in this act would lay the groundwork for inclusion of MNT in basic plans of insurance companies' [9]. This study describes and documents the current state of reimbursement for MNT by insurance companies throughout the United States.

METHODS

A systematic random sample was selected from the 2,016 home offices listed in the 1999 Medicode insurance directory [10]. Sample size was 404 (20%) companies.

A 4-page survey with 28 questions was developed based on surveys by the dietetic associations of Ohio [7], Massachusetts and Illinois (unpublished data, 1994). The survey was divided into a section identifying type of carrier and coverage for …