Beyond the Barriers: Alternative Payment Schemes may make Massage Therapy more Affordable.

Background: Massage therapy is an increasingly utilized user-pays service in Aotearoa New Zealand. People seek massage therapy for physical support, relaxation, and well-being. It is likely financially inaccessible to many and is generally not subsidized by the government; however, some private insurance companies in New Zealand provide limited cover for massage therapy sessions. Purpose: The aim of this project was to find out massage therapist (MT) and client perceptions of, and benefits and barriers to, using alternative payment schemes (APSs) to pay for massage therapy. These schemes included 'pay it forward,' 'pay what you wish,' and paying by installments. Setting: This project involved participants from Invercargill, Dunedin and Auckland, Aotearoa New Zealand. Participants: The participants were 12 employed MTs, and 7 massage therapy clients for whom cost was a barrier. Research design: This was a qualitative study using a semi-structured interview approach. Participants were interviewed either in person or over the phone. Results: Four themes emerged: financial contexts, APSs as a positive concept; considerations of administration, transparency and possible impacts; and installments as a preferred scheme. Massage is expensive, but many view it as an important investment in health and well-being. Owing to cost, massage is not utilized as often as needed. Perceived benefits to using an APS were increased accessibility and usage of massage therapy, resulting in potentially better health and well-being. Considerations for MTs centered around a lack of time and knowledge for scheme setup, a potential negative effect on the client-therapist relationship, and concern about losing money. For clients, considerations included uncomfortable feelings around accepting financial assistance and potential loss of money: a risk if funds had been prepaid toward a massage, and the therapist goes out of business before the massage was claimed. Overall, the installment scheme was preferred by MTs and massage clients. Conclusion: Massage therapy is a valuable health and wellness tool for many people. APSs may have a place in the industry as there may be enough interest from therapists and clients to engage in a system that is user-friendly, trustworthy, and safe, thus increasing the affordability and accessibility of massage therapy.