Offer Employee Assistance Programs
Employee Assistance Programs (EAP) are intervention programs that offer a variety of services to assist employees who are having personal or work-related problems. These programs can play an important role in assisting employees or their dependents who may be facing substance use issues by providing a confidential and easily accessible option for receiving necessary services. EAPs are separate entities from employers, meaning that any interaction with employees is private and not reported to the employer unless the employee authorizes it. EAPs can be voluntarily accessed by employees. Supervisors and managers can also initiate referrals in response to performance and conduct issues or identification of drug misuse or addiction.
EAP models and services can vary widely. When selecting an EAP, employers should consider how each option fits their budget, workforce, and general support and health-related goals. Employers should insist that their EAPs screen for risky substance use behaviors and provide referral services to evidencebased treatment programs. If an employer has the capacity, integrating an EAP at the worksite can help increase utilization, referrals, and care coordination. EAPs are an added expense to employers, but show measurable cost-savings benefits when implemented. Research shows that for every dollar invested in an EAP, employers have a return on investment ranging from $3 to $10.17 An added benefit to EAP implementation is its availability to all employees, not just those who are covered by employer-sponsored health insurance.
EAP services can include:
- Crisis Intervention
- Treatment Referral
- Short-Term and Follow-Up Counseling
- Treatment Monitoring
- Supervisor and Management Training
Improve Access to Behavioral Healthcare through Telemedicine
Telemedicine is a promising service in treating and supporting recovery for individuals with SUDs and acute or chronic pain. Telebehavioral health, both web and mobile, expands access to quality, timely, and evidence-based services, including screening, treatment, and consultation. These services are useful in navigating significant barriers to treatment, including transportation to facilities, privacy, missed time from work, and childcare.
Telemedicine services can be offered as part of a health plan package or directly through vendor relationships. Employers should consult both their health plans and pharmacy benefit managers to learn about the telemedicine platforms that they currently use, what types of services are offered, adequate reimbursement rates, and the quality of care demonstrated.
Consider Centers of Excellence and Alternative Payment Models
Employers should consider steering their members to Centers of Excellence (COEs) for comprehensive integrated pain management and addiction treatment. COEs are institutions that have demonstrated an exceptionally high level of expertise, resources, and outcomes for clinical areas of focus. Employers should talk to their health plan about COE options for their workforce.
Additionally, employers should consider talking to their health plans and consultants about payment reform models. Alternative Payment Models (APMs) are a payment approach that provides a different framework for paying for high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population. Bundled payments are a type of APM that provides a single, comprehensive payment covering all of the services involved in a patient’s episode of care. Several new bundled payments have recently emerged for SUD, including OUD. Some examples of some of these new bundled payment models include the the Patient-Centered Opioid Addiction Treatment (P-COAT) and Addiction Recovery Medical Home (ARMH.)
Alternative payment models also exist for many painful conditions. To improve outcomes related to these conditions and ultimately mitigate pain, employers should consider exploring models that coincide with both their health plan members’ top conditions and top conditions for which opioids are prescribed.
The benefits of these outcome-driven, complementary, and integrative pain management strategies for self-funded or financially at-risk organizations may lead to significant cost-savings to the plan when compared to conventional care models. The weaving of plan design, network adequacy and utilization management policies can be challenging to health plans and purchasers. There are an increasing number of new strategies for employers to bring these new models of care to their healthcare benefits.
Cover Screening in Primary Care Offices
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach to identifying high-risk substance use behaviors that is recommended to be conducted in primary care settings. Identification of risky substance use can help providers intervene with behaviors prior to the development of SUD or OUD. SBIRT is both an effective and cost-effective approach to the prevention of OUD and related harms. This service should be covered by your health plan and administered yearly to health plan members.
The Kentuckiana Health Collaborative has created resources for implementing SBIRT. Although intended for primary care providers, employers may consider reviewing these resources to become informed and initiate conversations with their health plans. View them here.