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Employers Addressing Substance Use Disorders Save By

Improving Substance Treatment Health Insurance Benefits

The Substance Use Disorder Cost Calculator for Business demonstrates that companies pay a hefty cost for untreated substance use disorders. But many companies offer health benefits to their employees that make getting effective treatment for substance use disorders difficult. The costs of untreated substance use disorder can easily exceed the cost of treating employees' substance use disorders.

Employers with successful track records in preventing and treating substance use work proactively to:
Offer equitable coverage: In 2008, Congress passed the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act. This act requires that employers who offer mental health and substance abuse benefits do so at a level commensurate with other medical and surgical benefits. Plan elements such as copayments, deductibles and treatment limitations for substance abuse and mental health services can be no more restrictive than the terms attached to general medical services. Most plans with 50 or more members will be required to meet these guidelines by January 1, 2010.

Recent evidence suggests that upgrading health insurance coverage to include equitable coverage for addiction to alcohol and other drugs in a managed care plan will increase premiums at most companies by 0.2 percent, as little as $5.00 per member per year.

One simple way employers can encourage health plans to provide access to drug and alcohol screening for employees is by remembering to ask a few key questions about a plan’s coverage and standards regarding substance use services:

  • Does the health plan cover confidential substance use screening for all employees and brief intervention services for individuals who would benefit from them?
  • Does the plan encourage physicians and other clinicians to screen for, diagnose and treat substance use problems in primary care settings, hospital emergency rooms and trauma centers?
  • Does the plan work with other health plans, treatment providers and community groups to promote common approaches to screening and treatment for drug and alcohol problems?

Other Solutions

Expect value: monitor the effectiveness of treatment: Expect more from your health plan and employee assistance program. Make sure that you are getting good value for your investment.

Offer state-of-the-art treatment: You can monitor the standards of the care that employees and family members with substance problems receive to be sure that treatment practices are effective and up to date. Nationally established standards can guide your evaluation.