Despite what recent headlines may lead you to believe, misuse and abuse of opioids, as well as dependence on these drugs, is not a new problem. Opium and some of its derivatives are millennia old. What is new is the growing impact in the workplace.

As prescriptions for medications to manage pain have increased, so have addiction and its consequences. This issue is far reaching and widespread, affecting organizations within every industry and region. Further, its effects spread well beyond the individuals involved and have negative repercussions for the entire organization.

Now is the time to take action to address opioids in your workplace.

Understanding the Disease of Dependence

The first step to addressing the issue of substance abuse in the workplace is to understand that chemical dependence on alcohol or drugs like opioids is a disease, not a moral failure. In the case of opioids, these substances have medicinal value for many people, however they are highly addictive.

The majority of issues start with a legitimate prescription to manage pain related to an injury or condition. Over time, this morphs into abuse or misuse, sometimes to the point where the affected person needs the drugs to function normally and may become sick without them. In order to help those negatively impacted by opioids, it is critical to remove the stigma attached to this issue.

Dependence on opioids has now reached pandemic proportions. The 2015 National Survey on Drug Use and Health found that more than 2 million Americans misuse or abuse prescription pain medications or heroin, another opioid.

There is no profile or demographic definition of someone misusing or abusing these substances – it affects all ages, genders, ethnicities, religions, education levels, tax brackets, areas of the country, and occupations. According to recent statistics from the Centers for Disease Control and Prevention, unintentional overdose deaths now exceed deaths caused by car accidents.

Acknowledging the Reality of Opioids

This problem is widespread, and if it’s not something you’ve encountered previously, unfortunately, it’s likely to occur in the near future. Because of the breadth and depth of opioid use in this country, it is important organizations acknowledge that this is occurring and may happen in their workplace. People rely on these medications all the time, and unfortunately, it can sometimes develop from medicinal use to addiction.

It may help to think of substance abuse in the same category as other chronic illnesses. It is a serious disease that, in many cases, cannot be prevented by the individual or their employer–however, it is possible to decrease risk to the organization if handled appropriately.

Reducing Risk to Create a Safe Work Environment

There are a number of strategies that can help organizations effectively minimize risk while protecting all employees.

  • Education and training. This is key to raising awareness of the issue among the entire workforce, including those affected who might be in denial. To reduce the stigma surrounding opioids, experts can help explain the difference between practical uses of these medications versus abuse, as well as how to identify those at risk. Rather than discussing only the dangers of opioid use, focus on how this issue impacts everyone, from personal and family issues to finances.
  • Ongoing support of all employees. Ensure programs and resources are in place to support the individual as well as those around them within and beyond the workplace. Keep in mind that employees who are not taking opioids themselves may have family members at home experiencing addiction, which can still impact their productivity, focus and health.
  • Reconsider policies. It is time to revisit zero tolerance or “drug free workplace” policies. Experience has shown that these can backfire and prevent people from seeking help. Further, some employees may need to responsibly take medications while at work to manage pain, not unlike treatment for other conditions. When creating or revising policies, focus on helping those in need, not punishing those impacted by this issue.

A safe work environment where employees feel supported is more productive and allows people to do their best work.

The Role of Employee Assistance Programs

There are many resources available to help organizations establish policies and take action to address opioids in the workplace, including Employee Assistance Programs (EAPs). For organizations who work with an EAP, experts are often available to offer insights on company policies, provide training to all employees and work with individuals who may be experiencing challenges that could indicate a potential issue.

Through onsite training, EAPs can help provide both a proactive and preventive response, helping to dispel myths around this issue and reset stereotypes or preconceived notions of “users.” By destigmatizing substance abuse and clarifying the role of EAPs, it is possible to more effectively identify employees who may need support or assistance, at which time the EAP can help with referrals to counseling or treatment as needed.

In the face of increasing misuse and abuse of opioids, their use continues to create challenges in the workplace as organizations determine the best path forward. Opioids can be a valuable, effective medication to manage pain and physical suffering—however it’s necessary to utilize available resources and provide education, support and treatment to address potential issues for those employees at risk.

Episode 9: Using Incentives to Drive Employee Wellbeing with Iris Tarou

Organizations are increasingly offering incentives to encourage employees to participate in workplace wellness programs, but do they work? In this episode of Health Advocate’s Ask the Expert series, Iris Tarou, Director of Wellness Program Services with Health Advocate, discusses how organizations can effectively apply incentives to increase engagement and achieve wellbeing goals.

Proprietary, data-driven provider evaluation tool utilizes machine learning to enhance clinical advocacy programs including specialty care and second opinions.

Plymouth Meeting, PA, September 20, 2017 – West’s Health Advocate Solutions, a leading clinical health advocacy company, announced today the launch of its new quality care evaluation tool, MEDIS(SM) (Medical Insights), a proprietary provider performance assessment engine. MEDIS has been incorporated into Health Advocate’s Specialty Care and Second Opinion assistance programs as an important new tool enabling its team of Personal Health Advocates to more effectively identify in-network, high-quality physicians.

“Connecting members with high-value, high-quality care is a vital first step toward improved outcomes,” said Abbie Leibowitz, M.D., Chief Medical Officer, Founder and President Emeritus of West’s Health Advocate Solutions. “Our Personal Health Advocates completed more than 80,000 specialty physician and second opinion searches last year, identifying and matching members to high-quality, expert physicians across the country. MEDIS will allow us to further refine our physician search process, enabling our Personal Health Advocates to provide enhanced treatment decision support to our members.”

MEDIS leverages a machine learning approach and is powered by proprietary, evidence-based, volumetric and quality analytic algorithms developed by engage2Health (e2H), Health Advocate’s data analytics division. Personal Health Advocates use MEDIS to enhance the provider search process for more than 50 elective specialty procedures. The tool currently includes data on more than 872,000 U.S. practicing physicians and will soon expand to permit facility searches as well. Utilizing national performance information to evaluate physician quality, MEDIS is continuously updated as new data become available.

“MEDIS allows us to expand the information our team uses to support members seeking a physician for specialty care and second opinions, continuing our focus on identifying leading academic medical centers nationwide – where cutting-edge treatments are developed and expert medical care is practiced,” said Dr. Raffi Terzian, Health Advocate’s Senior Medical Director.

About West’s Health Advocate Solutions

West’s Health Advocate Solutions makes healthcare easier for over 12,000 organizations and their employees and members nationwide.

Our solutions leverage a unique combination of personalized, compassionate support from healthcare experts using powerful predictive data analytics and a proprietary technology platform including mobile solutions to provide clinical support and engage members in their health and well-being.

Our members enjoy a best-in-class, personalized concierge service that addresses nearly every clinical, administrative, wellness or behavioral health need. Our clients benefit from high levels of engagement, improved employee productivity and health, and reduced medical costs, while simultaneously simplifying and upgrading their health benefits offerings.

By Abbie Leibowitz, M.D. | BenefitsPRO

The latest Large Employers’ Health Care Strategy and Plan Design Survey from the National Business Group on Health highlights a number of leading trends among employee health and benefits. While responses are from large employers, the results are often indicative of issues impacting businesses of all sizes across the country. Although prioritization and the impact of these issues may vary among organizations of different sizes, other matters are universal.

Topping this list is health care costs. Unsurprisingly, the survey found that participating employers anticipate health care costs will continue to rise. In an early estimate, average health care costs are projected to increase 5 percent in the next year, including both employer and employee contributions. These inexorable annual increases place a burden on both organizations and their employees.

Simultaneously, the complexity of health care is also increasing, leading to reduced productivity and utilization of benefit programs. Further contributing to the complicated benefits environment is the growing number of standalone services available to employees. While wellness programs, EAPs, pricing transparency tools, disease management programs and others may be valuable resources to help employees improve their overall health and well-being, employees facing a health issue are often overwhelmed and unsure where to turn for assistance.

In fact, a 2016 Health Advocate survey found that 42 percent of HR leaders partner with, on average, four to six benefits vendors to provide these programs. Although technology has a firmly established role in access to benefits information, the NBGH survey uncovered another trend. As organizations look to address both rising costs and complexity, they increasingly turn to high-touch, personalized, live-agent support services.

Rise of high-touch support services

Employee assistance programs (EAPs) and advocacy services have existed for quite some time. As health care has become more complicated, these services provide much needed assistance. In today’s health benefits environment, they are more important than ever and continue to adapt, evolve and grow to meet the changing and increasing needs of employees. While apps, websites and other tech tools are important complements to these services, they cannot replace the value of live support.

As organizations continue to adopt consumer-driven health plans (CDHPs), employees take on more responsibility for their health and need additional assistance navigating the complexities of the health care system. According to the NBGH survey, in 2018, 90 percent of large employers will offer a CDHP option, with a rising percentage making this the only available option. We’re now witnessing a correlation between the shift to CDHPs and the growing use of high-touch and decision support services, and data from the NBGH survey further establishes this.

Employers are seeking strategies, services and tools to help their employees both maximize their benefits and more easily access high-value care. Organizations surveyed by NBGH indicate the offering of these programs will increase up to 20 percent from 2017 to 2018, including medical decision support and second opinion services; advocacy and claims assistance resources; and high-touch concierge services. These services positively impact both employees and organizations as the health care system and employee benefits continue to become more complicated.

Benefits of advocacy and concierge tools

When companies implement third-party support services, the effects can be felt throughout the organization, including immediately relieving the strain on human resources staff. HR and benefits professionals are often stretched thin, especially during open enrollment. Advocacy services can function as HR outsourcers, assuming roles delegated to them for employee support during “Crunch Time.” Partnering with an advocacy service augments their bandwidth, enabling the HR and benefits teams to focus on the highest priority items.

For employees, these services “meet them where they are” by balancing emerging technologies with high-touch support, ensuring that their needs are effectively met in the way that works best for them. Although technology plays an important role, most interactions these days are “hybrids,” mixing digital navigation and live personal support.

As a complement to this, many support programs have the capability to enhance and personalize communications to engage employees and help them proactively take charge of their health. According to NBGH survey respondents, this is one of the most effective tactics to manage rising costs and dovetails well with advocacy services.

These services can also impact an organization’s bottom line. When experts step in to help troubleshoot challenging issues, it saves employees time, money and stress by taking this burden off their shoulders. Further, when employees are able to focus on work instead of personal health issues during the work day, productivity increases across the organization. Making the health care system function more efficiently and effectively for the user results in better outcomes and lower costs, creating savings that drop right to the bottom line.

Employers provide their workforce with a number of useful benefits. However, the sheer number can sometimes be overwhelming, leading to lack of engagement. As a partner to the organization, benefits support services can help raise awareness of available resources and ensure employees understand how to maximize their benefits. By guiding employees to cost-effective care, it is possible to lower overall costs for both employees and the organization.

While increased productivity and reduced costs are high priorities, the health and well-being of employees is paramount. Advocacy services provide a wealth of knowledge and expert decision support to help employees make informed choices and more easily access appropriate care. Combined with outreach to encourage more preventive care and condition management, these services can help move the needle toward better outcomes throughout the covered population.

High-touch, personalized support remains critical to assisting employees as they navigate the often confusing health care system. By incorporating these services into existing benefits offerings, organizations can achieve “the health care trifecta;” increased productivity, managed costs and improved health outcomes.

6 Smart Steps for Lowering Your Medical Bills

Are healthcare debts piling up? Our expert advice can help you cut those costs.

By Barbara Kiviat | Consumer Reports

When dealing with a daunting medical bill, such as an unexpected tab from a hospital stay, one approach many people overlook is negotiating a lower price. Insurance companies ask for (and get) huge discounts on posted rates. So why shouldn’t you?

Negotiating may make more sense than ever, with consumers shouldering the costs of higher deductibles and co-pays. No matter what happens in Washington, this trend is likely to continue.

According to a Kaiser Family Foundation survey, 20 percent of those 65 and older struggle to pay medical bills, as do 30 percent of working adults with health insurance. Almost half of Americans surveyed said they’d have trouble paying an unexpected medical bill of $500.

Sometimes you can see a big bill coming—if, for instance, you have a multi-­thousand-­dollar deductible. But medical bills can also take you by surprise. A 2015 nationally representative Consumer ­Reports survey of 2,200 adults found that 30 percent of privately insured Americans had received a medical bill where insurance covered less than they expected, leaving them on the hook for the rest.

Whether your bills are the result of a high deductible, an out-of-network charge, a procedure that’s not covered, or lack of insurance, experts say the following could help cut them up to half. (Regulations limit discounts under traditional Medicare, but providers have freer rein with Medicare Advantage and other health plans.)

How To Negotiate Effectively

It may feel odd to bargain with a healthcare provider. But “a lot of doctors are willing to do it—they understand,” says medical billing advocate Adria Gross, CEO of MedWise Insurance Advocacy. So:

Be proactive. For planned surgery, make sure your insurer covers the procedure and facility. Tiering (where consumers pay more for certain facilities) is on the rise. Ask your doctor whether everyone ­involved takes your insurance, and ­request a written response; that might help if you later learn that an out-­of-­network provider was used.

If you’ll be paying out of pocket, ask beforehand for a rate in line with what insurance companies pay. “When you deal with things that aren’t covered by insurance, there is a tremendous opportunity to discuss the fee and negotiate a discount off the posted charge,” says Abbie Leibowitz, M.D., chief medical officer of Health Advocate Solutions, an advocacy and health assistance company.

Do your research. Whether you’re negotiating in advance or after you get a bill, websites such as Fair Health and Healthcare Bluebook can help you determine what insurers pay in your area. “Say, ‘I know this is the reasonable and customary charge; can we come down a little bit?’ ” Gross suggests.

Talk to the right person. If you get a bill, check it to make sure it’s correct. Then ask your ­insurer if some or all will be covered. If not, call the provider who sent the bill. Start with someone in the billing department or patient financial counseling office, but don’t expect that to be your last stop. “The first response will be, ‘No, I can’t do anything,’ ” Leibowitz says. Keep asking for the manager of the person you’re talking to, until you get to someone with the authority to make a deal.

Offer to pay cash. If you can pay most of a bill, offer to do so immediately. Medical advocates say they can often get a 15 to 20 percent “prompt pay” discount this way. “They are running a business,” says James Napoli, CEO of Medliminal, which works with consumers and companies to reduce medical costs. “Appeal to their sense of a good business decision.”

Explain why you can’t pay. “If you are in retirement on a set income, that will play into it,” Napoli says. The possibility of not getting paid gives healthcare providers a reason to offer a discount or payment plan (ask that it be interest-free). Some states, such as California, require hospitals to provide free or reduced care to consumers within certain income limits. Ask whether yours does.

Enlist help. Many hospitals have patient advocates who can help you understand billing codes and pinpoint errors. Hiring a medical advocate is another option, though it can be expensive. Some take a flat fee, and others charge a percentage of what they save you (25 percent is typical). When considering advocates, ask for their track record and make sure they have experience with complicated medical billing codes.