Case Study: Falling EAP provider standards, rising health care costs

May 5, 2016 Steven Laird

Editor’s note: May is mental health awareness month in the U.S. This case study shows the value of reviewing your Employee Assistance Plan provider’s performance.

Knowing it is part of an industry with a high rate of substance abuse, a U.S.-based manufacturing company with 92,000 employees was concerned about the overall mental health of its employee population. In recent years, the company had become aware of an increase of substance abuse cases, more than one of which turned out to be catastrophic.

While the company was aware that there was a healthy utilization rate for its Employee Assistance Program (EAP), it was concerned its EAP provider wasn’t following evidence-based treatment protocols and that this lack of adherence to policies and procedures was significantly contributing to the company’s rising health care costs.

Significant deficiencies

The client wanted an objective assessment of its current EAP provider — focusing exclusively on its substance abuse services — and engaged us to conduct a thorough review of the EAP’s clinical processes, capabilities, and outcomes. Our clinical audit evaluated three major areas: was the incidence of substance abuse the company was experiencing falling within the industry average, was its EAP performing at established standards, and was its EAP following evidence-based treatment protocols?

The audit revealed significant deficiencies in follow-up and early intervention, both critical factors for success in substance abuse treatment programs. It also showed that the company was experiencing a lower than normal rate of substance abuse incidence, causing concern for the company because either its EAP was not correctly identifying substance abuse cases among its employee population or because its employees were not effectively utilizing this benefit.

Based on the results of the audit, the company knew it had to make changes quickly.

Pleased with the audit process and the knowledge of our team, the company asked us to develop and implement a corrective plan and to manage the vendor selection and implementation process. After discussing gaps in the company’s current EAP program and identifying areas for improvement, the team — using best practices, industry statistics, and EAP studies — recommended changes and enhancements to the program so that it could more effectively meet the needs of the employee population.

“Receiving regular follow-up calls and coaching from the same case manager made the difference in helping me maintain my sobriety for the long-term.”

– EAP Participant

(shared anonymously by EAP Provider with the company’s HR manager)

The new plan design set higher standards for prevention/early intervention and integration with other existing health offerings, including disease management, wellness, and medical and pharmacy benefits — both proven factors for long-term success and cost control. After the new plan design was in place, we initiated and managed the RFP process, and ultimately recommended a new EAP provider to the company.

$150,000 saved – and accountability back on track

The contract with the new EAP provider — negotiated by us — produced savings of $0.20 per employee per month, resulting in total annual savings for the company of more than $150,000. In addition, performance guarantees and reporting requirements have been put into place, providing the company with the ability to measure results and hold its vendor accountable for not performing at established standards. The company was impressed with the work of our team, and is pleased to offer an EAP program that both controls costs and more effectively meets the needs of its employee population.

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