The opioid crisis in the U.S. continues to gain attention, but it’s not going away. For recruiters and employers, acknowledging how the crisis is affecting, or will soon affect, their workplaces will be crucial. According to a survey by The Hartford, 67 percent of companies either have been or will be affected by opioid use.
That impact is largely monetary; in fact, the survey found that 65 percent of HR professionals said they’ve seen opioids have financial consequences on their company due to increased health care spending and employee productivity losses. Fortunately, HR professionals aren’t at addiction’s mercy. Today’s volume-driven, fee-for-service health care system — the status quo care incentivized by most health insurance plans — is a large part of the problem. And because an estimated 155 million Americans get their health insurance from their employer, employers have the power to stop addiction before it starts by designing health plans that ensure access to high-quality, value-based primary care.
The federal Bureau of Labor Statistics reports that in 2016 and 2017, 11.4 million Americans misused the opioids they were prescribed, and 2.1 million had what could be classified as an opioid-use disorder. Given opioid addiction’s prevalence — more than 115 Americans die from an opioid overdose each day on average — employers and HR pros must act now. A good starting point for those who have already felt the effects of addiction is to offer more opioid education and training. Sixty-four percent of the HR professionals and 76 percent of the employees included in The Hartford’s survey said they have not been trained on how to help addicted employees.
To take immediate action, employers and HR professionals should be aware of and communicate about the signs of opioid abuse and the signs of an overdose, and provide information on counseling programs to their workforce via presentations, workshops or online learning. Some states offer training sessions while others sell Narcan, an overdose-reversing drug, without requiring prescriptions. If Narcan is something that employers wish to have on hand, more training on how to administer the drug will be required.
However, these actions are only a Band-Aid — an attempt to fix the issue after the fact, sometimes after it’s too late. Rather than being continually on the defensive, employers can turn off the spigot that has been pouring addictive opioids into the hands of their employees. That spigot is the low-quality, expensive and ineffective primary care that most Americans receive through their current health plans. The solution is value-based primary care.
In a value-based-care setting, physicians make their money by producing positive patient outcomes. To do this physicians spend more time with patients and seek to thoroughly understand the root cause of their afflictions by talking through symptoms, lifestyle choices and multiple treatment options. With the big picture in mind, physicians can effectively treat the reason the patient has visited them and also recommend ways to improve overall well-being. In turn, employees are healthier — requiring fewer doctor appointments/prescriptions — and happier because fewer patient visits translate to shorter wait times and the ability to make same-day appointments. Further, value-based primary care includes telehealth, a way for patients to get in touch with their doctors via email/text/video if they don’t feel the need to make an in-person appointment. All these things save employers money.
Our current system doesn’t operate like this. Instead it incentivizes physicians for every test/procedure/drug they order, often bringing patients back into a physician’s office for follow-up appointments and referrals. When patients need to see a doctor more frequently it means longer wait times for everyone — it currently takes an average of 24 days to schedule a doctor’s appointment — and also shorter appointments. Wanting to keep patients satisfied and unable to spend ample time with them — every hour with a patient results in nearly two hours of paperwork — many physicians have routinely prescribed opioid painkillers like hydrocodone, oxycodone, morphine and benzodiazepines. These prescriptions are often excessive, evidenced by a JAMA Surgery study that found most people took only 27 percent of the opioids they were prescribed. And here we are.
So how can employers make the switch and offer their employees better benefits without breaking the bank? By working with a transparent benefits broker —one that’s willing to disclose any commissions and bonuses it receives from insurance carriers — to develop a self-insured health plan that favors value-based primary care. In a well-designed self-insured plan, employers forgo annual 5-20 percent insurance premium increases and use their own money to pay for employees’ medical expenses.
For a monthly fee, employers can also hire a third-party administrator (TPA) to process claims and perform administrative tasks. Doing so gives employers access to their claims data, allowing them to see what services, from what providers, they are spending the most money on. Finally, to protect against medically inappropriate large claims, put in place a Centers of Excellence program. Increasingly, wise employers realize sending employees to outstanding facilities like the Mayo Clinic is the best way to avoid surprisingly high rates of misdiagnosis and overtreatment. Many planned organ transplants actually turn out to be medically unnecessary after receiving a second opinion.
Once such a plan is in place, HR professionals should make sure that changes are made clear to employees via presentations, workshops, etc. Plan materials should also be distributed so employees have 24/7 access to the information they need, and HR personnel should be well-versed in plan details so they can answer employees’ coverage questions. The best health plans will still fail if they’re not appropriately executed.
There is no better time to direct your energy into creating health plans that provide your employees with high-quality benefits. Whether your business has already seen the opioid crisis’ effects or it has been lucky enough to thus far steer clear, there are actionable steps you can take today to not only address immediate needs but also prevent addiction from seeping into your workplace.