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What Can You Do?

Use this calculator. See for yourself the impact on your own business…

Armed with information from The Alcohol Cost Calculator for Business, you can strengthen your company’s programs. You can implement low-cost, high-gain practices to improve health outcomes and constrain costs.

Cover alcohol problems – and control health care costs as a result.

By providing alcohol treatment for employees, businesses can improve health and increase productivity while cutting down on costs of health care and personnel.

Workers and their families who have untreated alcohol problems cost their companies because they are likely to miss more days of work and require more emergency hospital care and longer hospital stays. Health care costs for employees who have alcohol problems are twice as high as for those who do not. In this period of rapidly escalating benefit costs, when businesses are paying more attention to health promotion and disease management, improvement of alcohol treatment is an important part of the cost-saving equation.

Solutions to Alcohol Problems

  • Build greater awareness of how to deter harmful alcohol problems, including through the establishment of clear company policies
  • Increase expectation of value from company health benefits to improve the provision of alcohol treatment
  • Establish the basic tools for employee assistance

Employers Addressing Alcohol Problems Save By

Increasing Awareness of Alcohol Issues

Along with strengthening health benefits and employee assistance programs, businesses can help employees at all levels of the company to become more aware of the consequences of and solutions to problem drinking.

Establish and Disseminate Treatment-Friendly Policies. Employees should know that they work in a place with treatment-oriented workplace policies. Company policies about alcohol and drug use, employee assistance services and health benefits should be highlighted in new employee orientation, company newsletters, personnel handbooks and similar corporate communications.

The Department of Labor and the Center for Substance Abuse Prevention have very helpful guidance in establishing treatment-oriented workplace policies.

Promoting Health and Wellness. Many companies make alcohol problem awareness part of their overall health education program.

Detecting and Treating Alcohol Problems Early. Through workplace screening and short sessions of counseling, called brief interventions, employees can become more aware of their own drinking habits and problems can be addressed before they become more intractable.

Other Solutions

Improve Alcohol Treatment Health Insurance Benefits

Assist Employees Facing Alcohol Problems

Promoting Health and Wellness Among Employees

Over the last decade, wellness, fitness and preventive health care have become important parts of many companies' human resource programs. Wellness programs that include information about hazardous alcohol use, along with diet and weight management, fitness and high blood pressure control are quite effective. One program developed by Max Heirich at the University of Michigan, the Wellness Outreach at Work, provides comprehensive health risk-reduction services to all employees at a workplace, using health screening, follow-up and worksite health promotion programs. The program has been used in more than 100 worksites and has reached more than 75,000 employees in organizations ranging in size from 5 to 6,000 blue- and white-collar employees.

Company Internet sites are tremendous resources for educating employees and their families about alcohol and other health problems. The Center for Substance Abuse Prevention, a government health agency, has created a Web-based educational resource that is free, effective, and can be incorporated into a company's employee Website. Ensuring Solutions has included this government resource in its Website at http://www.ensuringsolutions.atgetfit.net.

The U.S. Department of Agriculture's new Dietary Guidelines for Americans, released in January 2005, can be a tool to educating employees about moderate use of alcohol. According to the guidelines:

If adults choose to drink, they should have no more that 1-2 drinks a day. Moderation is defined as the consumption of up to one drink per day for women and up to two drinks per day for men. Twelve fluid ounces of regular beer, five fluid ounces of wine, or 1.5 fluid ounces of 80-proof distilled spirits count as one drink for purposes of explaining moderation. This definition of moderation is not intended as an average over several days but rather as the amount consumed on any single day.

The guidelines specify who ought not drink:

Alcoholic beverages should not be consumed by some individuals, including those who cannot restrict their alcohol intake, women of childbearing age who may become pregnant, pregnant and lactating women, children and adolescents, individuals taking medications that can interact with alcohol, and those with specific medical conditions. Individuals engaging in activities that require attention, skill, or coordination, such as driving or operating machinery, should avoid alcoholic beverages.

Companies have worked effectively with interested workers and organized labor to set up health promotion programs that include modules on alcohol problems. Currently, Ensuring Solutions is working with the U.S. Postal Service (USPS) and its district labor-management committees to increase awareness of the impact of harmful and hazardous alcohol use among USPS employees and their families. Find out how General Motors and the United Auto Workers reduced alcohol problems in their workplace through a health promotion program.

Use these tools and resources to educate workers about drinking

Increasing Awareness

Other Solutions

Disseminating Treatment-Friendly Workplace Policies

Every business should have clear policies on drinking and alcohol problems. All employees should know their company's policies and understand their rights and responsibilities. The policies can be distributed at orientation sessions for new employees and in posters and publications.

The U.S. Department of Labor provides many helpful resources to help businesses develop alcohol and drug policies tailored to their industry and to individual company needs.

Most companies with safety-sensitive transportation employees in the aviation, motor carrier, railroad and mass transportation sectors must have policies and programs regulated by the U.S. Department of Transportation. Ensuring Solutions has identified the likely occurrence of serious alcohol problems in 14 major occupational groups. Construction workers have the greatest alcohol dependence problem — nearly 19 percent, followed by laborers (17 percent) and farming, fishing and forestry workers (17 percent). Protective services, technical and professional workers were less than half that likely to have serious alcohol problems.

The federal government encourages an approach to company policies established through the Drug-Free Workplace programs. Companies doing business with the federal government and with many state governments are required by law to have these programs. In 11 states, companies with comprehensive Drug-Free Workplace programs get a bonus: 5-10 percent reductions in their workers' compensation premiums. The Department of Labor has a complete listing of Drug-Free Workplace laws, including those on workers' compensation premium reductions.

There are many reasons employees do not come forward to get treatment. Many fear that seeking alcohol treatment through their company Employee Assistance Program or health plan will get back to their employer and lead to termination or retaliation. Sometimes, their fears are well grounded. When employees know that their employer will assist them in getting help and will not punish them for getting treatment, they are more likely to come forward.

Increasing Awareness

Promoting Health and Wellness

Detecting and Dealing with Problems Early

Other Solutions

Improve Alcohol Treatment Health Insurance Benefits

Assist Employees Facing Alcohol Problems

Improving Alcohol Treatment Health Insurance Benefits

The Alcohol Cost Calculator for Business shows how companies pay a hefty cost for untreated alcohol problems. But many companies offer health benefits to their employees that make getting effective treatment for alcohol problems difficult. The costs of untreated alcohol problems can easily exceed the cost of treating employees' alcohol problems.

Employers with successful track records in preventing and treating alcohol problems work proactively to:

Offer equitable coverage: In 2008, Congress passed the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act.  This act requires that employers who offer mental health and substance abuse benefits do so at a level commensurate with other medical and surgical benefits.  Plan elements such as copayments, deductibles and treatment limitations for substance abuse and mental health services can be no more restrictive than the terms attached to general medical services.   Most plans with 50 or more members will be required to meet these guidelines by January 1, 2010. 

Recent evidence suggests that upgrading health insurance coverage to include equitable coverage for addiction to alcohol and other drugs in a managed care plan will increase premiums at most companies by 0.2 percent, as little as $5.00 per member per year.

Expect value: monitor the effectiveness of treatment: Expect more from your health plan and employee assistance program. Make sure that you are getting good value for your investment.

Offer state-of-the-art treatment: You can monitor the standards of the care that employees and family members with alcohol problems receive to be sure that treatment practices are effective and up to date. Nationally established standards can guide your evaluation.

Other Solutions

Increase Awareness of Alcohol Issues

Assist Employees Facing Alcohol Problems

Offering Equitable Coverage

Do you offer health insurance coverage for alcohol treatment that is comparable to that for other medical conditions and illnesses? Are the copays and deductibles the same as for other illnesses?

People needing treatment for alcohol problems put it off or drop out quickly if they feel they cannot afford alcohol treatment. A company that has a health insurance benefit that inhibits alcohol treatment may be penny wise and pound foolish. For example, a study by the RAND think tank found that one-third of patients with a copay of $25 or more for outpatient alcohol treatment did not follow up for outpatient treatment. Dropping copays to $10 increased follow-up more than 30 percent, and dropping copay completely increased outpatient use by more than 50 percent. The cost of lowering barriers can be as low as $5.00 per employee per year. Where state insurance laws require that alcohol treatment coverage be the same as that for other illnesses, a practice known as parity, people are much more likely to get services they need.

For more information about parity in health plans, see Workplace Solutions: Treating Alcohol Problems Through Employment-Based Health Insurance.

Improve Alcohol Treatment Health Insurance

Expecting Value: Monitoring Health Plans' Provision of Alcohol Treatment

Offering State-of-the-Art Treatment

Other Solutions

Increase Awareness of Alcohol Issues

Assist Employees Facing Alcohol Problems

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).

Improve Alcohol Treatment Health Insurance

Offering Health Benefits that Promote Alcohol Treatment

Offering State-of-the-Art Treatment

Other Solutions

Increase Awareness of Alcohol Issues

Assist Employees Facing Alcohol Problems

Offering State-of-the-Art Treatment

Patients often receive out-of-date treatment when they seek medical help for alcohol problems. While scientists have learned a great deal about addictions in the last two decades, the actual care for too many people with drinking problems lags behind. A 2003 study assessed the quality of treatment for the nation's 30 leading causes of death, illness, hospitalization and doctors' visits. The results, published in the New England Journal of Medicine, showed that the quality of alcohol treatment ranked dead last. Researchers found that just 10 percent of Americans with alcohol problems receive effective treatment that matches quality benchmarks recommended by alcohol treatment researchers and authoritative clinical practice standards.

What's more, up-to-date physicians now know more about what happens when people with serious alcohol problems suffer from other illnesses, such as depression, at the same time that they struggle with alcohol problems, but treatment for such co-occurring illnesses often goes unaddressed.

The Active Ingredients of Treatment

Ensuring Solutions has identified the 13 components of effective treatment. These are:

  • Early detection, including screening and brief interventions (for nondependent problem drinkers)
  • Comprehensive assessment and individualized treatment plan
  • Care management
  • Individually delivered, proven professional interventions
  • Contracting with patients
  • Social skills training
  • Medications
  • Specialized services for medical, psychiatric, employment or family problems
  • Continuing care
  • Strong bond with therapist or counselor
  • Longer duration (for alcohol dependent persons)
  • Participation in support groups
  • Strong patient motivation

National Standards

In 2004, the Health Plan Employer Data and Information Set, a widely used, standardized performance measurement tool developed by the National Committee for Quality Assurance, began asking health plans to measure how many people with alcohol problems they identify among their enrolled populations, as well as how quickly they initiate and engage them in treatment. Businesses will be able to benchmark their health plans with other health plans and to use this information to negotiate quality improvements. Ensuring Solutions recommends employers consider holding their health plans to at least these NCQA standards:

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

Using Performance Measurement to Improve the Quality of Addiction Treatment describes the impact of performance measurement on health treatment.

Other Resources

Chronic Disease Comparison Chart

Improve Alcohol Treatment Health Insurance

Offering Health Benefits that Promote Alcohol Treatment

Expecting Value: Monitoring Health Plans' Provision of Alcohol Treatment

Other Solutions

Increase Awareness of Alcohol Issues

Assist Employees Facing Alcohol Problems

Assisting Employees Facing Alcohol Problems

Workers with alcohol problems don't always seek help on their own. That's why it's important to assist workers in a variety of cost-effective ways.

A powerful step you can take: establish a formal, confidential Employee Assistance Program (EAP). Such programs provide the tools that enable employees to get referrals and interact with people who understand their work situation. Generally, EAPs serve 3-5 percent of employees each year. Many of the requests of the EAP are alcohol-related.

EAPs and health plans can also help by identifying and treating depression, a mental illness that frequently accompanies alcohol problems.

Even employers who have supported treatment for their workers don't always realize that a follow-up program is essential to the continued recovery of the employee with alcohol problems.

Other Solutions

Increase Awareness of Alcohol Issues

Improve Alcohol Treatment Health Insurance

Promoting Use of an Employee Assistance Program

Do you have and maintain an effective Employee Assistance Program (EAP) to help employees with personal and work problems?

Many companies provide EAPs to come to the aid of employees with alcohol, drug, family or emotional problems that negatively affect their job performance. The estimated 20,000 EAPs in the U.S. reach more than 48 million people. Workers who use EAPs report that after EAP treatment, they have fewer substance use and mental health problems, fewer health symptoms, better job attendance and greater job satisfaction.

Employee Assistance Program Achieves Positive Results

For workers with alcohol problems, EAPs generally include:

  • worksite awareness programs
  • referrals for diagnosis, treatment and other assistance
  • training of supervisors and union representatives
  • confidential and timely assessment
  • links to community-based services
  • Web-based tools
  • follow-up and recovery support after initial treatment

The federal government's Center for Substance Abuse Prevention offers a free Web-based information resource that can supplement companies' health and wellness programs.

Assist Employees With Alcohol Problems

Following Up Over the Long Term

Addressing Depression that Commonly Accompanies Alcohol Problems

Other Solutions

Increase Awareness of Alcohol Issues

Improve Alcohol Treatment Health Benefits

Following Up Over the Long Term

Continued monitoring and EAP supports for employees who have been treated for alcohol problems can preserve the investment that an employer has made in their treatment. Studies indicate that routine EAP or health plan follow-up for a year helps prevent relapse. Personal follow-up, including phone calls and handwritten notes for EAP providers or health plan care managers produces even better results.

Effective EAP follow-up can prevent employees who have been treated for alcohol problems from falling into old, destructive patterns of behavior by identifying "trigger mechanisms" — experiences that prompt cravings to drink — and referring clients to additional counseling services as needed.

Assist Employees With Alcohol Problems

Promoting Use of An Employee Assistance Program

Addressing Depression that Commonly Accompanies Alcohol Problems

Other Solutions

Increase Awareness of Alcohol Issues

Improve Alcohol Treatment Health Benefits

Addressing Depression That Commonly
Accompanies Alcohol Problems

Approximately one-fourth of workers with serious alcohol problems also have a co-occurring serious depression. Major depressive disorders are very common, and the medications to treat depression are frequently among the most commonly prescribed and most expensive drugs that businesses pay for through their health insurance. When an employee or her family member has both depression and alcohol problems, the costs and complications of treatment increase. To learn more about the extent of depression in the workplace and the return on investment that your company may get from investing in high-quality depression care, visit the Depression Calculator of the MacArthur Initiative on Depression in Primary Care.

Assist Employees With Alcohol Problems

Promoting Use of An Employee Assistance Program

Following Up Over the Long Term

Other Solutions

Increase Awareness of Alcohol Issues

Improve Alcohol Treatment Health Benefits