For some employers, population health management focuses only on the management of members who have chronic health conditions. For others, PHM supports members in all stages of health through a variety of services, such as wellness coaching, disease management and health assessments. Unfortunately, a significant hole exists in almost every PHM strategy: behavioral health. According to the Substance Abuse and Mental Health Services Administration, it's a gap that accounts for 7.3% ($135 billion) of the $1.85 trillion spent on all health care services in the U.S. each year.
By connecting an EAP with the other components of their health management initiative, employers can optimize their health care delivery model and plug the hole in their population health management strategy.
Group health plan: An employer can reduce direct medical costs by marketing the EAP as an entry point into mental health or substance abuse (MHSA) of the group health plan. Members with concerns that can be addressed with short-term counseling will be guided into the EAP; those with acute MHSA conditions will be referred to an in-network treatment channel within the health plan.
Telemedicine: Health reform, combined with an aging population and a shortage of available family physicians, is causing more employers to consider telemedicine as a solution to augment access to health care. Providers can refer members who present mental health or substance abuse concerns to the EAP for treatment.
Disease management: Behavioral health conditions elevate the risk of chronic physical health conditions, such as heart disease. An EAP provider can train a disease management partner on how to identify and refer members with comorbid behavioral health concerns into the EAP.
Health risk assessment tests: Most health risk assessments include screening mechanisms that identify members who have high-risk behavioral health or substance abuse concerns. An EAP can provide targeted outreach and treatment.
Onsite clinics: By training worksite physicians and nurses to act as referral avenues into the EAP, onsite clinics can provide holistic treatment.
Short-term disability: An EAP can reduce the length of time a member is on short-term disability leave, as well as the incidence of a repeat claim.
Long-term disability and FMLA: Extended leaves often impact the psychosocial condition of the claimant, which can be addressed effectively by an EAP.
Health and wellness coaching: In a manner similar to that of disease management, health coaches and EAP clinicians can exchange referrals and data regarding members with comorbid conditions with the goal of providing holistic treatment.
Pharmacy: The EAP can provide a clinical intervention and assessment to members who were prescribed a behavioral medication by anyone other than a behavioral health specialist.
Changes in the health care delivery landscape are driving unprecedented interest in health care models that focus on wellness and prevention. It's important that employers recognize the role behavioral health plays within their PHM strategy - and how an effective EAP can impact both direct and indirect costs.
Reach Fogarty, president of CuraLinc Healthcare, at
