{"id":4568,"date":"2019-08-02T11:11:55","date_gmt":"2019-08-02T15:11:55","guid":{"rendered":"https:\/\/www.healthadvocate.com\/site\/?p=4568"},"modified":"2020-01-14T17:00:30","modified_gmt":"2020-01-14T22:00:30","slug":"creating-a-new-normal-with-eaps","status":"publish","type":"post","link":"https:\/\/www.healthadvocate.com\/site\/article\/creating-a-new-normal-with-eaps","title":{"rendered":"Creating a new normal with EAPs"},"content":{"rendered":"\n<p><strong>By Alan Goforth | BenefitsPRO<\/strong><\/p>\n\n\n\n<p><em>Well-designed\nand implemented employee assistance plans can provide significant benefits to\nboth workers and employers.<\/em><\/p>\n\n\n\n<p>Workplace\nmental health issues often go unreported and unnoticed. The cost to employee\nhealth and employer productivity, however, can be every bit as substantial as\nthat caused by physical illness.<\/p>\n\n\n\n<p>\u201cWhen a person is experiencing a\npersonal issue outside of work, it often spills over into the workplace and\ninfluences other employees\u2019 productivity and morale,\u201d says Bert Alicea,\nexecutive vice president of EAP+Work\/Life Services for Health Advocate in\nPlymouth Meeting, Pennsylvania. The company offers a range of employee\nassistance programs (EAPs) and wellness benefits.<\/p>\n\n\n\n<p>\u201cFor example, if an employee is\nexperiencing substance abuse in their family and needs to make frequent phone\ncalls during the workday to address the issue, the employees around them may\nalso feel distracted, stressed or upset by the situation at hand,\u201d he says.<\/p>\n\n\n\n<p>Judi\nBraswell also sees a link between mental and physical health problems. Braswell\nis vice president, business development, for Behavioral Health Systems Inc. in\nBirmingham, Alabama, which administers a comprehensive suite of behavioral\nprograms for employers nationwide.<\/p>\n\n\n\n<p>\u201cResearch\nbears out the correlations between behavioral health issues and attendance,\nproductivity and safety,\u201d she says. \u201cThere is high comorbidity of behavioral\nhealth issues and chronic medical conditions, long recognized by employers as\nhaving an impact on workplace productivity and health care costs. A behavioral\nhealth program that can reduce non-compliance, provide education and actively\nengage members impacts not only the success and cost of those services but also\nphysical health, prescription costs and workers compensation claims.\u201d<\/p>\n\n\n\n<p>Statistics\nshow that a well-designed and implemented EAP can provide significant benefits\nto both workers and employers, says Rahul Mehra, M.D., CEO and chief physician\nexecutive for the National Center for Performance Health in Tampa.<\/p>\n\n\n\n<p>\u201cIn\nlarger, self-insured employer groups, a robust and responsive EAP can help save\nat least 30 percent in mental health claims, reduce emergency visits and reduce\nmedical and pharmacy claims,\u201d he says.<\/p>\n\n\n\n<p><strong>Bumps\nin the road<\/strong><\/p>\n\n\n\n<p>This\nleads to an obvious question: If mental health is such a pressing issue and\nEAPs are part of the solution, why are they often not as effective as they\ncould be? Mehra has three general answers:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Stigma,\nwhich is improving but still faces huge hurdles.<\/li><li>Lack\nof awareness and education, such as health care literacy in mental health.<\/li><li>Access\nissues. Only 55 percent of practicing psychiatrists take private health\ninsurance, which is the lowest number of any physician specialty.<\/li><\/ul>\n\n\n\n<p>The structure of many EAPs, which are\nembedded in medical plans, is another part of the problem, Alicea says. \u201cWhile\nsome people with mental health or substance abuse issues may utilize the\nservice, those with temporary setbacks in life may not reach out for assistance.\nThe medical benefit may be viewed as something to use only in the instance of a\nserious problem. If employees view the service as something that is only\navailable for issues on the severe end of the spectrum, they may not reach out\nin the earlier stages when it is possible to address issues before they\nescalate.\u201d<\/p>\n\n\n\n<p>Braswell\npoints out that before medical parity, most health plans covered mental health\nand substance abuse on a limited basis, often capping exposure at a set dollar\namount for outpatient and number of days for inpatient care.<\/p>\n\n\n\n<p>\u201cEAPs\nbegan to reduce their cost, and competition resulted in very low cost for\nservices on a capitated, per-employee, per-month fee,\u201d she says. \u201cThat also\nresulted in little to no promotion or employee communications, limited network\noptions or services provided by a limited number of providers employed by the\nEAP. As a result, they are very underutilized. Some companies felt the\nprogram\u2019s low utilization meant they had no value in the workplace, with no\nreturn on investment from the capitated cost. While some companies continue\nwith EAPs and accept this as just the way it is, others elected to not provide\nthe services.\u201d<\/p>\n\n\n\n<p>The\ngood news is that many employers are gaining a better understanding of the\nbenefits of mental health EAPs.<\/p>\n\n\n\n<p>\u201cWe\nare beginning to see a shift in employers recognizing the need for behavioral\nhealth services in the workplace beyond a poster with an 800 number,\u201d Braswell\nsays. \u201cWith mental health and substance abuse benefits now on the same\ncost-sharing structure as physical health benefits, and with arbitrary limits\nremoved, employers are recognizing the need to provide services to assist in\nearlier problem identification, easy access to quality providers and workplace\nsupport, such as management consultation on problem employees, critical\nincident response and development of effective communication campaigns.\u201d<\/p>\n\n\n\n<p><strong>Reducing\nthe stigma<\/strong><\/p>\n\n\n\n<p>One of the biggest challenges for\nbrokers and employers is the stigma often attached to engaging mental health\nservices. Employees who would not think twice about seeing a doctor for an\nillness or injury often are reluctant to seek help with depression or a\nstressful situation at home. Alicea recommends shifting the focus to temporary\nsetbacks.<\/p>\n\n\n\n<p>\u201cPosition the EAP as an educational\nresource with mental health and substance abuse components without focusing\nentirely on mental health,\u201d he says. \u201cThis can help employees feel more\ncomfortable reaching out for help by not putting a label on what they may be\nexperiencing.\u201d<\/p>\n\n\n\n<p>Just\nas with any other benefit, communication is essential. \u201cEAP utilization is\ndriven by communications that are relevant and at the point the member is\nexperiencing difficulty,\u201d Braswell says. \u201cManagement acceptance and their\nknowledge about EAPs is a major factor in utilization by employees. Supervisors\nwho are supportive of seeking assistance and know how the process works help\ndispel the myth that we shouldn\u2019t need assistance. Normalizing seeking\nassistance for personal problems by integrating it in wellness initiatives can\nbe very helpful.\u201d<\/p>\n\n\n\n<p>Employers\nshould position mental health benefits as part of an overall health and\nwellness plan.<\/p>\n\n\n\n<p>\u201cIt is important to recognize that\nmental health issues do not happen in a silo,\u201d Alicea says. \u201cBy integrating the\nEAP with other services, including advocacy and wellness, it not only makes\nmanaging benefits programs simpler for employers, but it can also help to\nidentify issues much earlier.<\/p>\n\n\n\n<p>\u201cWe\u2019ve found that a large percentage of\nreferrals to our EAP originate from a medical issue with underlying emotional\nconcerns. While the member may not have originally reached out for EAP support,\nit was still possible to connect them to services that could help them\nholistically address the issue at hand.\u201d<\/p>\n\n\n\n<p><strong>Role\nof brokers<\/strong><\/p>\n\n\n\n<p>Brokers\ncan do several things to help their clients maximize their return on a mental\nhealth EAP.<\/p>\n\n\n\n<p><strong>Do\nthe homework.<\/strong> \u201cBrokers\nwho have an understanding of the components of the EAP are better able to match\nemployers to the program that can best meet their needs,\u201d Braswell says. \u201cIt\u2019s\nhelpful for brokers to at least know how account management is handled; who\ntakes the calls and makes the referrals; how much flexibility exists in plan\ndesign; what the capacity is for training and communication campaigns; if that\nis driven by the company or if the EAP works with company personnel to monitor\nevents that may warrant education; and if utilization trends are considered.<\/p>\n\n\n\n<p>\u201cIt\u2019s\nalso important to know if the company values the cost savings and flexibility\nthat come from self-insuring or the budget consistency of a capitated program\nthat must clearly define what is included in the plan and set a rate that will\ncover the cost of delivering all of the services that could be utilized, even\nif they are not.\u201d<\/p>\n\n\n\n<p><strong>Demonstrate value.<\/strong>\n\u201cIf you have 5 percent utilization for EAP services, it is possible to achieve\na 10-to-1 return on investment, which does not take into account services\nbeyond clinical utilization, including manager consultations, on-site training\nand support, and more,\u201d Alicea says. \u201cLook at other aspects of the EAP and not\nsolely clinical utilization in order to appreciate and understand the true\nvalue.\u201d<\/p>\n\n\n\n<p><strong>Make\nit specific.<\/strong> \u201cThere are\na number of EAP models,\u201d Braswell says, \u201cincluding assess and refer, where a\ntreatment plan is developed and the member is referred for the treatment within\ntheir insurance or as private pay; those that allow members to use all sessions\navailable before referral; those that offer access to a network; those that\nallow access only to their employed staff; programs that offer access only to\nmental health professionals; those that also include psychologists and\npsychiatrists; models that allow access only for non-clinical issues, such as\ngrief, marital and family but not clinical issues such as eating disorders and\nmanic depression; as well as variances in communication and training\ncapabilities.\u201d<\/p>\n\n\n\n<p><strong>Maximize access.<\/strong>\n\u201cWe have found that making it easier for people to access EAP resources from\nanywhere helps drive utilization,\u201d Alicea says. \u201cEmployees want to know that\nwhen they access the EAP, it is confidential and their privacy is protected.\nFor example, offering videos, self-assessment tools, webinars and more enables\nthem to get the information they need from the comfort of home or anywhere,\nreally. This also extends to how employees access live support, including chat\nfunctionality on EAP websites, to protect their privacy and make the experience\neasier.\u201d<\/p>\n\n\n\n<p><strong>Be\nvisible.<\/strong> Mehra and his\nteam make a conscious effort to be the face of the EAP.<\/p>\n\n\n\n<p>\u201cWe\nattend open enrollment meetings, do lunch-and-learns and educate HR staff of\nsupervisory referrals,\u201d he says. \u201cWe also provide responsive on-site crisis\ncounseling related to traumatic events in the workplace. NCPH also meets with\nsenior management. A lot of effort is spent in building trust with the\nleadership of the organization such that a culture is created that supports\nemotional well-being.\u201d<\/p>\n\n\n\n<p>\u201cEAPs can be a valuable partner to HR, managers and employees and dependents they serve if they have a seat at the table and are a visible presence,\u201d Braswell says. <\/p>\n\n\n\n<p>Engaging employees in effective mental health EAPs is simply the right thing to do from a human perspective. It also is a smart choice for employers trying to boost productivity and brokers looking to expand their product portfolios. <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Well-designed and implemented employee assistance plans can provide significant benefits to both workers and employers.<\/p>\n","protected":false},"author":11,"featured_media":1118,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[5],"tags":[201,93,52,51,46,202],"class_list":["post-4568","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-article","tag-behavioral-health","tag-bert-alicea","tag-eap","tag-employee-assistance","tag-health-advocate","tag-mental-health"],"acf":[],"yoast_head":"<!-- This site is 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