Employers Addressing Alcohol Problems Save By
Expecting Value: Monitoring Health Plans'
Provision of Alcohol Treatment
Would you purchase a piece of equipment for your business if you knew that it routinely injured your employees and that safer equipment was readily available at a comparable cost? No? Well, why would you buy health insurance that hurts employees with alcohol problems by failing to adequately address this health crisis, one of the nation's most pervasive (and expensive) health problems?
A quick check of the numbers will show whether your health insurance benefit is working. Most health plans use a standard report card, the National Committee on Quality Assurance (NCQA) Health Plan Employer Data and Information Set. There are three required alcohol and drug treatment measures: rates of identifying substance use problems; rates of starting treatment; and rates of engaging patients in continuing care. Your health plans should be at least average, and many employers are setting stretch goals for their health plans like the following:
|Identification of alcohol problems||at least 3 percent of all covered beneficiaries|
|Initiation into treatment||at least 66 percent of all patients identified|
|Engagement in treatment||at least 50 percent of all patients who start alcohol treatment|
If your health insurance plan is below average, your health plan design or the way it is being managed needs improvement.
Work with Other Businesses
Companies can work with others — national and regional business coalitions on health — to combine their purchasing muscle to push health quality. Business groups are putting improved quality of care for alcohol problems on their health quality agendas. The National Business Coalition on Health (NBCH), one of the leading organizations of businesses pushing health care quality, conducts an annual assessment of health plan quality through its eValue8 RFI. The business coalitions and large employers such as General Motors, American Express, Marriott International and Pitney-Bowes that participate in the eValue8 RFI set out very clear expectations of alcohol screening and treatment quality that they expect their health plans to meet. These businesses are asking:
- Do health plans cover confidential alcohol screening for all employees and brief intervention services for individuals who are not yet dependent on alcohol?
- Do they encourage health care providers such as primary care physicians, hospital emergency departments and trauma centers to screen, diagnose and treat alcohol problems?
- Do they provide guidance about alcohol problems and treatment to health practitioners who provide services in the areas of mental health, substance abuse, developmental disabilities and sexual health?
- Do they monitor how effectively health providers assist people with substance abuse problems?
- Do health plans work with other health plans, treatment providers and community groups to promote common approaches to screening and treatment for alcohol problems?
The Mid-Atlantic Business Group on Health, for example, is using the results from the NBCH survey to set as its first priority quality improvement goal in 2005. The group hopes to improve alcohol screening and treatment by the four largest health plans in the Baltimore-Washington metropolitan area.
Ensuring Solutions to Alcohol Problems offers guidance for improving alcohol treatment benefits in your company's health plan(s).