Checklist A Fresh Look at Behavioral Health Benefits

Checklist A Fresh Look at Behavioral Health Benefits

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Checklist A Fresh Look at Behavioral Health Benefits
Calendar20 June 2016

Here are a couple of eye-opening statistics. Behavioral health issues account for 4% of all medical claims on average, yet contribute to 21% of health care costs[1]. And for employers, there are other consequences of failing to address behavioral health in the workplace: Costs associated with employee absenteeism and lack of productivity due to behavioral health issues account for nearly $17 billion dollars annually[2].

Employers across the country have noticed an uptick in medical claims related to behavioral health. One driving force behind this trend is substance use disorders in the adult dependent population (dependents ages 19-26 who are covered on their parents’ employer medical plan).  

Here are some actions that employers can take to address behavioral health in the workplace:

  • Integrate behavioral health resources
    • Start with your EAP. Examine ways to integrate EAP services with your behavioral health coverage, whether offered through the medical plan or a carve-out vendor. Establishing formal referral practices will help ensure members receive the right care at the right time.
    • Have an employee well-being program? Find out if the vendor or carrier offers a behavioral health screening tool to help members self-identify a need for behavioral health services. Be sure your well-being partner includes referral information to EAP and other relevant benefits on their portal.
    • Talk to your medical carrier about utilization management. What are they doing to address out-of-network use for mental health and substance abuse services? Are behavioral health issues considered primary conditions within their case management services?
  • Boost engagement with the EAP
    • EAPs are often underutilized, in part because employees don’t know their services are available. Work with your EAP provider to create custom marketing campaigns that motivate members to use the service. Promote any work-life services offered, such as child-care concierge and financial and legal advice.
    • EAPs can provide acute behavioral health care services. Effective referral pathways between your medical carrier and the EAP can get members who can benefit from EAP to the right care.
    • Innovative EAP providers are leveraging technology to deliver enhanced services: web-based mindfulness solutions and cognitive behavioral therapy; tele-mental health services; video counseling; and text message interaction.
  • Assess your organization’s culture
    • Do employees feel comfortable addressing behavioral health issues in the workplace, or is stigma preventing individuals from seeking the care they need? Publicly available resources on addressing mental health stigma are available. (National Alliance on Mental Illness, Partnership for Workplace Mental Health)
    • Consider developing behavioral health policies, including a vision statement, and specific objectives around behavioral health in the workplace.
  • Ensure compliance Mental Health Parity & Addiction Equity Act (MHPAEA). A parity assessment might be appropriate if:
    • You have a carve-out behavioral health vendor
    • You recently changed your benefit design or cost-sharing
    • You have a tiered network
    • Your plan has exclusions or limitations on certain levels of care for mental health and substance abuse
    • You have medical management or other non-quantitative limitations in your plan design

[1] Melek S, Norris D. Chronic Conditions and Comorbid Psychological Disorders. Seattle: Milliman, 2008.

[2] Hertz RP, Baker CL. The impact of mental disorders on work. Pfizer Outcomes Research. Publication No P0002981. Pfizer; 2002

This post is part of our 2017 Planning Checklist series.

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