Until about seven months ago, “cohort” was not a word that was included in my day-to-day vocabulary. Now, it’s in rotation about as much as “hi,” “please,” “thank you,” and “I need more coffee.” This changed was spurred by the KHC’s employer-based initiative to form a cohort of their peers to partner in addressing the opioid crisis. The “Opioids and the Workplace” toolkit provided theoretical recommendations for employers to begin doing this. Next, our goal was to take these recommendations into action.
Our problem was clear: with an unprecedented rise in opioid misuse and opioid-related overdoses in the United States and Kentucky, employers are experiencing challenges related to productivity, absenteeism, hiring, retention, healthcare costs, workplace culture, and employee health. Our objective was action-driven: collectively prepare employers throughout Kentucky to leverage their positions as healthcare purchasers and employee support systems to improve access to evidence-based prevention, treatment, and recovery services for opioid use disorder and to maintain a healthy, loyal, and productive workforce.
On November 1, the KHC convened the first meeting of this cohort, “Addressing Opioid Misuse and Pain: A Six-Month Employer Journey.” In the room, we had 22 employers who have committed to working collectively to address Kentucky’s Opioid Crisis. These 22 employers represented 10% of Kentuckians, 11% of Kentucky workers, and 23% of Kentuckians with employer-sponsored insurance.
The first meeting’s focus was on the prevention of opioid use disorder through benefit design. To kick off the conversation, employers learned the basics of the opioid crisis, its impact on the workplace, and the basics of addiction as a chronic brain disease – all critical pieces of information as they move forward in this learning experience. Next, the group learned of tangible ways that they could change health benefits to support prevention, including the coverage of alternative pain management modalities, employee assistance programs (EAPS), site-of-use disposal technologies, and Screening, Brief Intervention, and Referral to Treatment (SBIRT).
There to share their workplace’s successes, challenges, and next steps in this area, was Jason Parrot, Senior Manager of Global Healthcare and Wellbeing at The Boeing Company. The Boeing Company has been taking significant strides over the past five years to curb risks related to opioid misuse and educate their employees. Boeing leveraged a data-driven and collaborative approach by working with their pharmacy benefit manager (PBM), dental administrator, behavioral health administrator, and medical plan administrator to reduce unnecessary opioid prescribing. To complement these efforts, the company launching an educational pilot among their employees and providers who are prescribing opioids.
Jason’s presentation kicked off a dialogue. A keystone of the employer cohort was the opportunity for employers to have a candid discussion on what they were experiencing related to substance and opioid misuse. Often, the employer/employee experience is shrouded by stigma and privacy. In this meeting, employers challenged this notion and had an engaging discussion on what prevention looked like in their workforce. They explored topics such as the availability of non-opioid pain management alternatives in their health plan and whether cost-sharing, prior authorization, or coverage limitations impeded their health plan members’ ability to access them. The efficacy of EAPs was explored and what challenges were being faced in ensuring that they met the substance use-related needs of workforces. The workplace availability of Naloxone (Narcan) was also discussed. Employers inquired about the training and safety of the life-saving drug’s administration and provided solutions to one another on how access can be expanded in their workforce.
The next meeting will convene on January 17, 2020 and focus on how treatment and recovery services can be supported through benefit design. In the meantime, cohort members are taking information back to their workforce and examining how it can be applied. They are staying engaged with the KHC and each through interactive dialogue and networking. Additionally, the group is participating in supplementary webinars to maximize their learning experience.
My vocabulary isn’t the only area I foresee evolving over this journey. The employer members of this cohort recognize the role they must play in supporting their employees and their loved ones as they face opioid-related challenges. Together, we will identify how benefit design, workplace policies, culture, and ultimately lives can be changed for the better.