Boost utilization and successful outcomes through integration

The key to the success of programs like Employee Assistance Programs lies in ensuring high levels of utilization and successful outcomes between users and the services. While our systemic implementation process and customized promotion have helped our clients average a utilization rate of 9% or higher, one key area that needs to be considered as well is integration. By integrating the Employee Assistance Program with other benefits, systems, and initiatives of an organization, you will see two primary benefits:

1. Enhanced awareness and utilization of the EAP services – When all benefit providers and wellness programs are integrated with one another, information can be shared from multiple sources ensuring all members and employees are aware of the services available to them. Additionally, when an employee or member learns about another benefit, such as the EAP, from their primary care doctor or through an onsite clinic at work, they are better able to connect the dots between the service and the issues they may be tackling in their everyday lives making it much more likely they will proactively reach out and access services.
2. Creation of a holistic care system – By creating a holistic benefit suite that successfully integrates employee benefits and an organization’s other health and wellness initiatives, cross-referral between providers is made possible which helps to ensure employees and members are receiving all possible services available to them that may be relevant to issues they are dealing with and co-morbid conditions that necessitate more than one area of care. Increased coordination between providers can also expedite the rate that care is accessed allowing employees and members to resolve wellness and health issues faster and more efficiently.

Integration opportunities

While integration opportunities will vary from one group to the next, the following represents some common and key integration areas to consider. The MINES Team is always happy to discuss and collaborate around these areas or any others that your organization would like to explore with us.

• Health Plan
  • MINES collects other accepted insurance information from our EAP providers. When requested by a caller, and/or deemed necessary through the assessment, we will send referrals for providers who are in both networks. This allows for a seamless transition from EAP to the behavioral health component of their medical plan should their concern not be resolved within their allotted EAP sessions.
• Short and Long-Term Disability
  • MINES could proactively outreach and effectively counsel employees who have been placed on leave such as FMLA, workers compensation, ADA, STD, or LTD, to assist with the primary concern, life adjustment, and associated loss. The purpose of the outreach would be to ensure that the client on leave is aware of all of the benefits available to them including and not limited to :
    • Counseling: Being on leave can be stressful for the individual and family. There also may be mental health impacts related to identity, PTSD, etc. depending on the leave.
    • Financial coaching (often those on leave are receiving fewer wages and might need support with budgeting).
    • Wellness coaching to help get the member on leave back on track and help with healthy coping strategies.
    • Parent and lactation coaching
    • Work-life: There may be services that the EAP can support such as someone to assist with errands if the impacted member is unable to.
    • Legal referrals: Some on leave may need support legally (for non-work-related issues). An example would be a car accident or a fall in a public place.

Such an intervention, which may or may not include the family, could result in quicker recovery, and minimize likelihood of secondary injury development. MINES could further be involved in the recommendation and/or release to duty from disability.

• Disease and Case Management
  • MINES could partner with the disease and case management teams of an organization’s health plan carrier(s). When the carrier identifies a chronically ill member with a behavioral health concern comorbidity, they can bring MINES in to help. MINES has found that many cases under the disease/case management that may look like physical conditions (such as diabetes, heart disease, etc.) often have a comorbid behavioral health diagnosis or condition. When the behavioral health and physical health conditions are treated together, positive outcome rates increase significantly.
• Organizational Health and Wellness Initiatives
  • MINES can partner with an organizations’ internal health and wellbeing intiatives. We want to collaborate and connect to internal solutions. An example of a collaboration effort would be if an organization has a healthy eating initaitive, MINES could connect our board-certified wellness coaches into support those who want to learn more about healthy eating. The organization could also utilize their training hours to provide education around the desired iniative such as “Nutrition and Aging- Eating for a Longer Life.” The work-life services could also help them find fitness classes, gyms, and restaurants that fit their dietary goals.
• Organizational Policy
  • MINES assists with policy and human resource consultation. Working with MINES provides a consultant with HR and/or organizational psychology expertise at your fingertips.
• On-site or Near-Site Clinics
  • MINES can both make and receive referrals from on-site medical clinics as clinically indicated. MINES recommends working collaboratively with the on-site clinic partner to include ways to trigger providers to refer to the EAP or on-site counselor such as though assessments or other testing results. In addition to the counseling services, MINES recommends that the clinics also have awareness of the services that can be useful to the providers and clients as well. MINES can also staff an onsite or near-site clinic with a clinician, either in person or virtually. This arrangement tends to be in addition to the EAP and allows increased access to all members of the organization.

How could MINES integrate with your organization? Call us today, we would love to talk about!

To your (and your organization’s) wellbeing,

-The MINES Team

The post A Word on EAP Integration appeared first on MINES and Associates.

The integration needs to occur at the strategic/systems and tactical levels. On the tactical side, there are already case studies in the public healthcare sectors and in Kaiser Permanente of placing mental health professionals in medical clinics and offices so the doctors and nurses can just walk a patient down the hall to see them once a psychological component has been identified. At MINES we are piloting a wellness coaching model for individuals who are identified by their healthcare provider as a pre-substance use disorder patient, through a Screening, Brief Intervention, and Referral to Treatment (SBIRT) grant awarded to Peer Assistance Services.

At the strategic/systems level, integration has significant utility and challenges for self-insured organizations whether as an individual entity or a multi-employer trust. At this level, a key component is the ability for the various vendors to cross-communicate on these types of patients. This involves the ability to do data mining to identify the patients, having an intensive case management behavioral health specialist to be the point person, regular communication between the TPA, pharmaceutical vendor, medical utilization review, behavioral health utilization review and the medical/psychological personnel responsible for treatment. An obvious challenge is getting buy-in from all of these stakeholders. There is no incentive other than good patient care for any of these groups to cooperate with each other. To rectify this, incentives would need to be financial or contractual. Employers have leverage on the contractual side as it is their health benefit and their money. At the time of this blog, there are case-studies of organizations moving this direction; however, specifics are a long way from full integration due to the complexities required.

I would welcome your discussion and wisdom on this issue.

Have a day filled with extending loving kindness to all those you encounter,

Bob

Robert A. Mines, Ph.D., CEO

The post Psychology of Performance – 42: Integration of Behavioral Health and Medicine in Self-Insured Organizations appeared first on MINES and Associates.