Employers, Substance Abuse, and Behavioral Health Costs

Substance Abuse

Today, Substance use disorders affect 20.8 million Americans. 75% of these people are part of the workforce and most employers are blind to the hidden costs associated with these problems. Using drugs impairs decision-making abilities and physically impairs people. This is a dangerous duo when on the job. In fact, 10-20% of American workers who die at work have a positive result when tested for drugs or alcohol.

While individuals and communities across the country are struggling with prescription opioid misuse, addiction, and overdose, this health crisis has made its way into our workplaces. According to a recent nationwide survey released by the National Safety Council, 71 percent of employers said they are directly impacted by prescription drug misuse in their workplaces. Common issues include absenteeism, increased costs, decreased productivity, on-the-job injuries and fatalities, and even employee arrests.

Some effects of substance abuse in the workforce include poor work performance, frequent call outs or late arrivals to the workplace, frequent change of workplaces, productivity struggles, injuries, fatalities, theft, low employee morale and filings for workers’ compensation claims and benefits. These are just a few of the many consequences that come as a result of substance abuse in the workforce.

The reality is that healthcare costs for employees who misuse prescription drugs are three times the costs for an average employee. In fact, according to the Centers for Disease Control and Prevention (CDC), in 2013 alone, prescription opioid dependence, abuse, and overdose cost the United States $78.5 billion. More than one-third of this amount—$29 billion—is due to increased healthcare and treatment costs.

Tackling the opioid crisis requires coordination across health plans, provider networks, PBMs, pharmacies, providers, employers, and many other constituents. This is a complex problem that goes beyond what any one group can influence.

A company that is striving to combat the nationwide opioid and polysubstance use epidemic is MediXall.com. MediXall.com is a new generation healthcare marketplace platform designed to address the growing need of self-pay and high deductible consumers for greater transparency and price competition in their healthcare costs. The MediXall.com platform makes scheduling an appointment for specific healthcare services as simple and easy as booking a flight and hotel.

MediXall will be teaming up with CoreChoice, MINES and Associates, and LifeWIRE Group to provide the first PPO network for a comprehensive behavioral health program. For over 37 years MINES & Associates has been a nationally recognized, award-winning business psychology firm that provides a variety of services to employers including employee assistance programs (EAP), managed behavioral healthcare, organizational development services, wellness programs, behavioral risk management, disease management, PPO services, and other behavioral health programs serving a diverse portfolio of clients nationwide.

LifeWIRE operates throughout North America with offices in Richmond, Virginia and Toronto, Canada. Providing a secure and interactive communication engine and population management tool through the LifeWIRE platform, organizations are able to communicate with individuals under their care anywhere, at any time, through any device. For the individual, it means they can engage when they want, how they want, about what and with whom they want at any time. As valuable as the two–way response is to the organization and the individual, it is the ‘non-response as a response’ that is also monitored and equally valuable. All LifeWIRE interactions are recorded and validated to FDA audit standards, tracked on a date/time basis, and managed by our clients. Captured data is used for advanced analytics that includes customer engagement levels, customer behavior, service, and operational levels, performance measurement, and predictive modeling.

The network contains 24,000 providers nationwide consisting of inpatient treatment centers, outpatient treatment centers, physicians, behavioral health specialists, and labs. This integrative network is contracted with aggressive discounts ranging between 50-80% OFF billed charges and can be set up based on each specific client’s needs and protocols. Combined with MediXall.com’s partnership with a national based laboratory, it will provide exceptional quality testing products and service at the lowest price point to clients that participate in the network. Additionally, the program is designed to service the commercial group health and the workers’ compensation insurance sectors.

For self-insured employers, as well as companies in the commercial group health and the workers’ compensation insurance sectors, the network will ensure strict protocols for evaluation and treatment, complete monitoring and tracking of prescription and lab results, and transparency between results and patient claims. This will include treatment for patients who are addicted to opioids, stimulants, central nervous system depressants, alcohol, illicit substances, as well as other prescription and over-the-counter drugs. As many of these patients also have underlying behavioral health issues, the network will also be able to provide treatment for depression, anxiety, stress, post-traumatic stress disorders, detoxification and other related problems.

The program is structured with two different program levels. There will be a typical PPO model for the repricing of bills as well as a true managed care model. The managed care model will allow for direct referral to a Network Care Coordinator who will be able to place the patient in the appropriate treatment setting, get initial comprehensive and interim evaluations, and monitor results. Claims will be handled through the CoreChoice Electronic Data Interface technology. Managed care processes will utilize MINES’ integrated case management protocols and the behavioral health opioid and substance use Network will use MINES’ specialty network.

This network will not only address substance use in the workplace but also combat the issue of mental health in the workplace. Globally, an estimated 264 million people suffer from depression, one of the leading causes of disability. There are many risk factors for mental health that may be present in the workforce. Most risks relate to interactions between type of work, the work environment, the skills and competencies of employees, and the support available for employees to carry out their work.

Patients with behavioral health conditions cost an estimated $752 billion in healthcare expenditures annually. It’s clear that addressing substance use and behavioral health in the workplace is vital to running a successful business. Supporting healthier employees will directly support a healthier business!


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