What health vendors aren’t telling you now
February 18, 2009 by Bill MeltzerPosted in: Healthcare costs, Special Report, Wellness
The organizations with the most cost-efficient health plans are the ones that streamline the services employees receive for both their physical and mental health.
As a long-term goal, having your general health plan, employee assistance program (EAP) and wellness program communicating regularly with one another about employees’ treatments is the single best way to reduce redundant or contradictory treatments, eliminate unnecessary claims and improve the quality of the plans for which you pay.
Let’s look at the relationship between your wellness program and your EAP to illustrate the importance of attacking health costs cross a broad front.
You can start a wellness program with a health risk assessment and then, if appropriate, roll out a smoking cessation program or a weight loss program.
But ultimately you want to make sure that your wellness vendor works in conjunction with your EAP vendor.
Here’s why: It’s very common for an employee to contact the EAP because the person feels depressed about his or her weight. What you want is for the EAP vendor to treat the employee’s depression and behavioral issues, plus you want the EAP to refer the employee to the wellness program to deal with the root cause of the problem – obesity.
The same thing goes with the relationship your wellness plan and your workers’ comp vendor, STD and LTD vendors, rehab people, and/or disease managers. You want all them talking to – and sharing data with – each other. If they’re not, it’s costing you money.
In general, the employers who achieve the greatest cost savings through their wellness programs are the ones who overlap wellness with behavioral and occupational health issues.
Tags: Plan shopping
February 19th, 2009 at 5:28 pm
I see some potential HIPAA violations here.
February 19th, 2009 at 5:58 pm
On this surface this looks like a POSITIVE thing. In reality this is a NIGHTMARE. Personally, I have seen many times where something that appears beneficial and makes sense turn into a MONSTER. If I use EAP I do so because I am seeking help and don’t want everyone to know. It is my responsibility and choice to do this. I have seen too many instances where someone in the guise of helping exerts pressure to do something (stop smoking, diet, quit drinking, exercise, etc.). It quickly goes from a beneficial program of choice to a NANNY Program.
I can support if I go to EAP and they suggest that they talk to the Health Plan or Wellness Program and I can decide “Yay or Nay.” If my employer tried to get me to implement a program like this without employees having a choice, I would be extremely vocal about my concerns. If the employer insists, then I would have to seriously consider changing employers because I consider this immoral and prone to discrimination, harassment, abuse, and a violation of the trust an employee places in an organization when they share ANY personal information.
February 20th, 2009 at 10:01 am
I hope the writer of this author did NOT intend that EAP, wellness vendor, medical carrier, etc. would correspond with each other WITHOUT the employees’ consent. That could indeed constitute HIPAA violations. In that case, I agree with both Randi and Mike R…
If the EAP counselor suggests that the employee work with the wellness vendor, that’s one thing. The ee can even give his consent for EAP to work directly with them (by signing a written release, of course). But like Mike, I would be outraged if I learned that they “consipred” to “help” me without my express written consent!
February 21st, 2009 at 8:38 am
So … you state: “… The organizations with the most cost-efficient health plans are the ones that streamline the services employees receive for both their physical and mental health. … having your general health plan, employee assistance program (EAP) and wellness program communicating regularly with one another …”
Who is doing this today? What organizations, what vendors? How do you expect this to change once the Mental Health Parity Act and the Americans With Disabilities Act Amendments fully take effect/kick in?
May 21st, 2009 at 1:03 pm
I am sorry but here we go again, this time it’s not goverment but the medical industry of who does what and when and penalize if its not done to their discretion – nothing but a bunch of hog wash, it looks like people in HR will have to become attorneys or hire attorneys in order to protect not only the employee but the employer, and without employers there is no other place to go but the goverment, and looking at how it’s going I think all of us will be headed that way or another.
this is leading to the medical insurance companies or medical care givers to start making decisions on private individual lives and it all comes down to money and who controls who. One made a comment above – about employers doing this – read between the lines they are going to begin to be forced to – one way or another – people the money has to come from some where and eventually the printing press will stop because what it’s printing is not going to be worth anything.