Mindfulness-Based Stress Reduction Health Insurance Coverage: If, How, and When? An Integrated Knowledge Translation (iKT) Delphi Key Informant Analysis.
Study Goal
The researchers aimed to identify key questions, barriers, facilitators, and priority evidence needed to inform health insurance coverage decisions for Mindfulness-Based Stress Reduction (MBSR) in the United States.
Results Summary
The study found that the most highly rated factors for MBSR coverage included research demonstrating its effectiveness and safety, while barriers included its non-medical treatment status and patient attendance issues. Facilitators included MBSR's potential to address mental health and psychosomatic problems, and the highest priority evidence needed was understanding which conditions MBSR effectively treats and its impact on stress.
Population
Key informants (n=26) including health insurers, healthcare administrators, policymakers, clinicians, MBSR instructors, and MBSR students.
Effective Dosage
Not Assessed
Duration
Not Assessed
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mindfulness-Based Stress Reduction (MBSR) | neutral | - | - | - | works | #1 |
Mindfulness-Based Stress Reduction (MBSR) | no change | - | - | - | is not harmful | #2 |
Mindfulness-Based Stress Reduction (MBSR) | decrease | common mental health and psychosomatic problems | - | - | has the potential to address | #3 |
Mindfulness-Based Stress Reduction (MBSR) | decrease | stress | - | - | has an impact on | #4 |
OBJECTIVES: Hundreds of trials have evaluated Mindfulness-Based Stress Reduction (MBSR), but in the United States, it is generally not covered by health insurance. Consequently, the aims were to identify the following: (1) key questions to make decisions about if, how, and when MBSR should be covered by health insurance; (2a) barriers and (2b) facilitators to understand and resolve for MBSR to be covered by health insurance; and (3) highest priority evidence needed to inform health insurance coverage decisions. METHODS: Key informants (n = 26) included health insurers, healthcare administrators, policymakers, clinicians, MBSR instructors, and MBSR students. An initial pool of items related to the study aims was generated through qualitative interviews. Through the Delphi process, participants rated, discussed, and re-rated each item's relevance. Items were required to reach a consensus of ≥ 80% agreement to be retained for final inclusion. RESULTS: Of the original 149 items, 42 (28.2%) met the ≥ 80% agreement criterion and were retained for final inclusion. The most highly rated items informing whether MBSR should be covered by health insurance included research demonstrating that MBSR works and that it is not harmful. The most highly rated barriers to coverage were that MBSR is not a medical treatment and patient barriers to attendance. Highly rated facilitators included the potential of MBSR to address common mental health and psychosomatic problems. Finally, understanding what conditions are effectively treated with MBSR and the impact of MBSR on stress were rated as the highest priority evidence needed to inform health insurance coverage decisions. CONCLUSIONS: Findings highlight priorities for future research and policy efforts to advance health insurance coverage of MBSR in the United States. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12671-024-02366-x.