Interest in mindfulness, the practice of maintaining a heightened awareness of your thoughts, emotions, and experiences, reached a new high during the lonely and stressful months after the breakout of the COVID-19 pandemic. With roots in ancient Buddhist meditation, modern mindfulness treatments have been shown to reduce anxiety and depression, and are linked with improvements in blood pressure, sleep and even pain reduction. [1] Now, a team of scientists is hoping to show the effectiveness of an intensive form of the practice called mindfulness-based stress reduction (MBSR), with an eye toward someday getting the treatment covered by health insurance.
The road to health insurance coverage
Many people are familiar with mindfulness through apps like Headspace or Calm, which include meditations as short as five minutes. MBSR, is an outpatient therapy developed in 1979 by professor and meditation expert Jon Kabat-Zinn that typically includes eight weekly classes lasting two-and-a-half hours each, and one all-day class each weekend. There’s currently no billing code for this treatment, says Eric Loucks, director of the Mindfulness Center at Brown University and an associate professor at the Brown School of Public Health.
Loucks and Blair Johnson, a professor of psychology at the University of Connecticut, are leading a team of researchers to conduct a study, funded by grants from the National Institutes of Health, on the efficacy of MBSR. One focus of the grant is whether the treatment merits coverage from private health insurance, as well as public programs like Medicare and Medicaid. Based on interviews with health insurance companies and policymakers, the team of researchers working on the study aim to see whether MBSR is effective enough to be worth covering.
Health insurance coverage could make MBSR more affordable — an eight-week course costs $400 to $600, though some programs offer a sliding scale based on income. And it may make it more possible for more practitioners to offer MBSR, increasing access to the treatment, Loucks says. Mindfulness could offer an alternative to the stigma of seeking other forms of mental health treatment as well, like talk therapy or prescription drugs. Health benefits offered through the U.S. Department of Veterans Affairs already cover a variety of mindfulness treatments. [2]
The growing evidence base for mindfulness
The evidence that MBSR can help treat conditions like anxiety, depression, pain, and overall quality of life has mounted over the past few years thanks to what one study called an “explosive growth” in research. [3]
“The evidence base has really exponentially increased,” Loucks says.
Now, the research is focusing on how to implement mindfulness treatments in the real world. One thing health insurance companies are keenly interested in is evidence of the costs and benefits of MBSR, Johnson says. Does the treatment improve physical health as well as reduce stress? Will it keep people out of emergency rooms? What’s the ideal form of MBSR?
“We’re really at the starting blocks right now,” Johnson says.
The evidence for the benefits of mindfulness is growing, but health insurance companies will need to be convinced of the cost-effectiveness if they’re going to cover MBSR.
“This is a moment in history for carefully considering health insurance coverage for evidence-based mindfulness programs,” Loucks says. “Can we hit that tipping point, if the evidence supports it?”
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