Therapy Services Reinstated in Missouri MedicaidAfter Key Policy Recommendations

Faculty; Policy; Public Health

The State of Missouri recently announced that it is amending its Medicaid Plan to allow for alternative therapies treatments for chronic pain, including services provided by acupuncturists, chiropractors, and physical therapists, effective April 1.

This important policy change is similar to a suite of policy recommendations considered in discussions held over the last year, in meetings sponsored by the Center for Health Economics & Policy (CHEP) at the Institute for Public Health and the Clark-Fox Policy Institute at the Brown School at Washington University.

“This change provides patients with tools other than narcotics to help alleviate their pain,” said Tim McBride, Bernard Becker Professor at Washington University and director of CHEP. “We heard in our discussions with key policymakers and providers that patients suffering with pain only had the alternative of using prescription medications, including opioids. The policy change thus could be an effective way that Missouri can limit dependence on narcotics and help combat the current opioid crisis.”

As the state of Missouri Medicaid leadership began discussing this policy change, discussions of this policy change in October 2017, when CHEP and the Clark-Fox Policy Institute hosted an event, Transforming Healthcare in Missouri: Ideas for Innovation and Investment to generate ideas for improving healthcare in Missouri.

One of the key recommendations offered to officials was to reinstitute coverage for therapy services for Medicaid beneficiaries to improve the health of Missourians.

In 2005, Missouri cut Medicaid expenditures, including access to physical and occupational therapy. Prior to the cuts, patients were routinely referred for physical or occupational therapy post-joint replacement surgery in order to keep the joint mobile. Without the availability of physical therapy, narcotics became the primary mechanism for treating chronic pain, which frequently led to narcotic dependence.

Gary Parker, director of the Clark-Fox Policy Institute, commended state leaders for helping advance better health outcomes for Missourians, particularly Dr. Randall Williams, director of the Missouri Department of Health and Senior Services, who fully participated in the October convening.

“Every effort to reduce the opioid epidemic is critical and helps protect families from the terrible impacts of this crisis,” Parker said. “In addition, this change comes with a significant estimated cost-savings to Missouri of $10 million in the first year. This is both effective and practical policy. We are so pleased that our work and recommendations helped to implement this change.”

The Alternative Therapies for Chronic Pain State Plan Amendment will go into effect April 1, 2019.

For access to the full list of prioritized challenges and recommendations from the October 2017 Transforming Healthcare event, click here. For a full list of recommendations from the October 2018 Transforming Healthcare event, click here.

For more information about Missouri’s commitment to combating the opioid crisis, visit this site: