© 2024. Contigo Health, LLC. All rights reserved.

SUD is costing employers and the workplace.

The modern work environment is changing and evolving quickly, and the pressures on employees have never been greater. Hence the rise in substance use, which in the end costs employers. The annual cost of a SUD diagnosis in 2018 for employers who self-insure was $15,640 per affected health plan member and $35.3 billion in the U.S. population.² Overall, lost productivity from SUD costs employers $25.5 billion a year, and workers with untreated SUD miss nearly 50% more days a year than their peers.³ Absenteeism from substance use isn’t simply inconvenient; it creates serious productivity issues as well.

Jobs are either not being done or are not being done correctly, and employees under the influence in the workplace are a danger not only to themselves but to others. This is especially true in industries like manufacturing and transportation, where lives could be on the line. All of this may lead to employers incurring costs such as hiring replacement workers or adding to others’ workloads, which makes for low morale and a less-than-optimum company culture. But the real loss is to the affected employee. Without treatment, they will struggle to reach their full potential both in the work environment and life.

According to Quit Genius, turnover is another significant issue facing employers as a direct result of SUD.⁴ Twenty-five percent of employees report having had more than one employer in the past year. That number rises dramatically to 36% among employees with SUD. Productivity suffers when people change jobs frequently and onboarding has to happen. Replacing employees is also expensive. From recruitment to training new employees, the cost burden for the employer is approximately 21% of a job’s annual salary. No matter how you dissect the cost of SUD in the workplace, you’ll see it’s a problem that employers need to notice and address.

SUD is costing us all.

While we are able to quantify what SUD costs employers and the workplace to operate, the societal costs are immeasurable. From diseases, hypertension, mental health issues, and premature death to the cost of interdiction, law enforcement, prosecution, and incarceration, society pays dearly for SUD. Consumers pay in the form of higher prices for goods and services.⁵ Employers and employees pay higher health insurance premiums, and we all pay higher taxes for healthcare, law enforcement, and treatment programs.⁶

But it’s the personal costs that are the hardest to measure and heaviest to bear. Poor health, broken relationships, and financial hardships are but a few of the tolls that SUD takes. When someone has a family member suffering from SUD, it can impact their own ability to focus at work and may cause financial hardship, reduce their own job retention, and increase anxiety and depression.

Children are also adversely affected by this affliction. Many people don’t realize that exposure to SUD and adverse

childhood experiences is associated with increased risk for health problems across a lifespan.⁷ The ripple effect of SUD throughout society is unmistakable and costly. But we must remember that SUD isn’t the result of an individual’s moral failing but is rather a chronic condition that needs to be treated.

Contigo Health offers a revolutionary new approach to treating SUD.

The costs of SUD both financially and emotionally are alarming—so alarming that they inspired us to react with a revolutionary new approach to treating it. Our program is designed to be everything traditional care isn’t. It’s discreet, allowing employees to work without having to share personal struggles with their employer in industries that don’t have mandatory drug screening. It allows a person to continue on with their life while seeking treatment. And it’s accepting, welcoming all with open arms, with special consideration for members of the LGBTQ+ community and diverse populations.

What makes our SUD treatment program so unique?

We offer immediate support, 24/7. After an initial triage call and determination is made about the right level of treatment, health plan members are referred to licensed counselors for a detailed assessment. Then the health plan member will begin receiving treatment from one of our trusted partners. For outpatient care there’s Lionrock Behavioral Health, Inc., who pioneered virtual outpatient SUD treatment and continues to lead the way in virtual care with great success. If in-person treatment is needed, we offer access to our world-class partner Hazelden Betty Ford Foundation. Everyone has a different need. What makes our SUD program so unique, aside from its superior support, is that a health plan member can access the full spectrum of care within one program and within multiple modalities.

Now virtual care from home can happen, which removes the barrier of access and allows for far less life disruption. One-on-one sessions, support groups, and group sessions can all be handled outside of work with virtual treatments, so the person doesn’t have to leave their family or job. No matter the treatment, our program wraps its arms around the individual and gives them high-quality care and social support, surrounding them with a success-driven team that’s with them all the way.

This team of professionals will help continue treatment for however long it’s needed to achieve success and maintain recovery. This revolutionary way of treating plan members is a part of our Centers of Excellence transformation. We call it Contigo Health Centers of Excellence 360™, a first-of-its-kind, guided comprehensive care journey. It’s the next phase in making plan member care more accessible and effective.

The cost of SUD in the workplace is something that forward-thinking employers know they must address with new and innovative treatment options. To that end, the number of employers offering Centers of Excellence for SUD leapt from 20% in 2022 to 34% in 2023, and another 19% might implement it in 2024.⁸  But while SUD’s impact on the workplace is measurable in dollars and cents, it’s the impact SUD has on the lives of employees and dependents that makes up the real cost. And it’s this real cost, this immeasurable cost, that drives us to find and offer more revolutionary treatment to help get people back to living their best, most productive lives possible.

© 2024. Contigo Health, LLC. All rights reserved.

InsideOut Podcast
June 15, 2023

© 2024. Contigo Health, LLC. All rights reserved.

Introduction

According to a national survey, employers recognize that their health benefits plans are playing a more pronounced role in attracting and retaining employees, especially since the pandemic. Two-thirds of employers consider health benefits as vitally important in their management of talent. But while employers are seeking to expand their health benefits offerings—a broader provider network being one of the most important factors—they are highly concerned about managing the cost of care. The latter point is particularly significant as most employers (60%) have seen their healthcare costs outpace inflation over the past three years and expect that trend to continue.¹

While many health plan provider networks are comprehensive, plan members still venture beyond the reach of their primary network. Whether they are traveling or close to home, employees and their dependents sometimes choose to engage providers that are not within their plan’s established network. That’s when a wrap network comes in.

Wrap networks are designed to enable access to care when plan members do opt to seek care from a specialist that is not in the health plan’s primary network. The challenge for employers is that with little or no provider fee boundaries nor sufficient pricing transparency, out-of-network care is often financially distressing to health plans and the employees and families they serve. While employers are willing to give their health plan members the choice to seek care out of network, there is also a need to establish greater cost control for that care. Unfortunately, HR decision makers tend to have little familiarity with and understanding of wrap networks.

The employers who are familiar tend to be satisfied with the breadth and quality of their wrap network but are often extremely dissatisfied with the associated expenditure. These employers consider the most important attributes of a viable wrap network solution to be controlling the cost of access to providers, pricing transparency, and cost savings greater than currently available options.

Considering the lack of awareness and understanding of wrap networks and the level of dissatisfaction with the cost of out-of-network care, there is a significant opportunity for a better wrap network solution, one that delivers valued network breadth while also directly lowering medical claims costs through defined discounts and pricing transparency—in other words, building a wrap network that delivers on what matters most to employer-funded health plans. There is substantial employer interest in ConfigureNet™, a compelling wrap network model from Contigo Health® intended to address the access-versus-cost challenge by extending comprehensive coverage in all 50 U.S. states and across specialties while simultaneously introducing a level of cost savings through pre-negotiated provider pricing and a streamlined process that is direct to employers.

The high cost of out-of-network care

Out-of-network care has traditionally been more costly to a health plan and its members than in-network care. Out-of-network providers have had the freedom to charge higher rates since they are not bound by the health plan’s contracted primary provider network reimbursement. Out-of-network providers have no obligation to accept the reimbursement amount the health plan is willing to pay its in-network providers. This commonly leads to the practice of balance billing, where the provider charges the patient an amount above what the health plan paid and up to the provider’s originally billed amount. This can be an unpleasant surprise to health plan members and the health plan itself.

Beyond the provider reimbursement difference, the medical claims repricing progression often involves multiple intermediaries providing various services for which each can take its own administrative fee, adding more unexpected administrative cost to the health plan.

Contigo Health, LLC, as an architect of financially sustainable healthcare, has taken steps to identify a key area where a more contemporary model with real cost controls and pricing transparency could help employers address the care and cost imbalance of out-of-network care.

A survey about wrap networks

To gain a better understanding of current perceptions about wrap networks, and to reveal what gaps and opportunities there may be to improve those networks, a study was conducted by Stonegate in April of 2022.²

The survey focused primarily on input from health system employers—specifically HR decision makers and health system executives. This audience represents leadership in healthcare delivery, intimate knowledge of healthcare infrastructure and pricing, and perspective as one of the largest employers in a market. The findings complement broader industry studies regarding employer perceptions of care versus cost. The results revealed four distinct areas of interest for anyone desiring to create a better wrap network solution for their health plan.

Four things that employers should know about wrap networks

1. Health plan decision makers don’t tend to understand wrap networks.

An interesting discovery from the Stonegate study is that employers, by and large, do not appear to have a strong awareness of wrap networks, let alone an understanding of the costs associated with such networks. Among the HR decision makers surveyed:

• Nearly 1 in 3 (28%) are very unfamiliar with the term “wrap network.”
• Most (57%) admitted they don’t understand the costs associated with their current wrap network. Just 43% said that they definitely understand the costs.

This gap in understanding is an opportunity for a new wrap network solution that can deliver needed clarity, consistency, simplicity, and support. For those that do have an understanding of their wrap networks, the study revealed some valuable insight into what matters most to them, as is revealed in the next sections.

2. Breadth and quality get high marks. Cost, not so much.

The Stonegate-conducted study asked employers to identify the best and worst attributes of their current wrap network. The survey revealed that health plan decision makers are largely satisfied with their current wrap networks when it comes to the breadth and quality of network access.

• 85% are extremely satisfied with the extent of their wrap network
• 85% are extremely satisfied with the quality of network access

HR decision makers identified the following as the most important wrap network access and quality attributes.

Importance of access and quality attributes to HR decision makers

As encouraging as that is, employers are clearly less than satisfied and more concerned with the cost of that access. In fact, cost is the highest area of dissatisfaction among health system employers surveyed specific to wrap networks. Nearly half (46%) of HR decision makers indicated they are neutral to extremely dissatisfied with the cost of their wrap network access. That percentage may be conservative considering, in section 1, it was revealed that 57% of HR decision makers surveyed do not even understand the costs associated with their wrap networks.

3. It comes down to economics.

The aspects of a wrap network that rose to the top among health plan decision makers surveyed by Stonegate consistently involved three areas: cost containment, pricing transparency, and cost savings. These are the characteristics identified as VERY IMPORTANT to employers:

• 100% indicated cost-containment when accessing out-of-network providers
• 100% emphasized pricing transparency
• 92% want more savings than what’s currently available
• 92% want a configurable wrap solution that meets their specific needs

Importance of economic wrap network attributes to HR decision makers

In consideration of the first three core study findings listed above, it is evident there is call for a more suitable wrap network solution for employers than is currently available. A better wrap network product would directly address employers’ cost concerns without compromising their plan’s access to care. The optimal solution would deliver on all the things that matter most to employers, including breadth and depth of their wrap network access, plus significant cost savings beyond the industry status quo, along with much-needed pricing transparency—in other words, securing the lowest possible price and eliminating unexpected charges without compromising access to care.

4. One solution is showing great promise.

There is significant interest among health system HR decision makers and executives in a new wrap network product pioneered by Contigo Health. Known as Contigo Health® ConfigureNet™, this contemporary wrap network product is structured to provide the coast-to-coast national coverage and key specialties that employers value highly. The wrap is differentiated in that it has been designed to introduce significantly discounted provider rates and a high level of pricing transparency, combining to enable a level of cost savings greater than what is currently available in the market. As the name suggests, ConfigureNet™ is also designed to eventually become configurable to meet the distinct needs of individual employers.

Developed specifically to meet the needs most emphasized by employers, ConfigureNet™ provides health plans with robust out-of-network provider access at a lower cost. The following features directly address those expressed needs:

ConfigureNet™ introduces nationwide access to contracted healthcare providers with pre-negotiated discounts in place for a full range of provider services including:

A majority of Stonegate survey respondents find the ConfigureNet™ wrap network concept very appealing.

How executives view the ConfigureNet™ wrap network concept

How HR decision makers view the ConfigureNet™ wrap network concept

Contigo Health’s ConfigureNet™ out-of-network wrap solution has tremendous appeal because it addresses employers’ most pressing wrap network concerns while presenting features that matter most. Fifty percent of surveyed executives would definitely consider switching their wrap network if doing so would provide financial benefits to their organization. A third of HR decision makers and 30% of executives would consider carving out their wrap network from their current plan.

What solution will you bring to your health plan?

ConfigureNet™ has tremendous appeal to employers because it addresses their most significant wrap network concerns directly and delivers the attributes that matter most. Fifty percent of executives surveyed would “definitely consider switching” their wrap network if doing so would have financial benefits for their organization. That is why 37% of executives expressed they would be very interested in a no-cost consultation to compare the costs of ConfigureNet™ to their existing wrap network.

Leveraging its ConfigureNet™ nationwide provider network, Contigo Health has also created ConfigureNet™ Price Advantage, a flexible plug-in that gives employers a smart, “on-demand” repricing solution when and where it is needed most. It can be implemented as their dedicated
out-of-network cost-containment solution, or configured as a cost-saving option to expand the power of out-of-network cost containment solutions that may already be in place. Price Advantage was designed to be a no-risk, no obligation alternative.

See how Contigo Health can help you establish clear savings on your out-of-network wrap by conducting a complimentary out-of-network wrap cost analysis for each.

How it works:

1. You share health plan claims data

2. Contigo Health analyzes the health plan’s existing out-of-network claims data for the past year and identifies savings potential (two-week turnaround)

3. We meet to review and discuss savings opportunity and quote

4. Contigo Health creates a contract to make an easy and frictionless switch

1. Aditya Gupta, Nikhil Mahajan, Carolina Malcher, Monica Qian, Matthew Scally, and Jeris Stueland, “Employers Look to Expand Health Benefits While Managing Medical Costs,” McKinsey & Company Employer Health Benefits Survey (May 25, 2022) source
2. ConfigureNetTM and Beckers, Health Plan Wrap Networks Perceptions survey (conducted by Stonegate), April 2022

© 2024. Contigo Health, LLC. All rights reserved.

MobiHealthNews
April 20, 2023

Health systems are facing a difficult financial future as labor costs soar and the population ages, increasing demand just as hospitals have less resources to serve them, said panelists at the 2023 HIMSS Global Health Conference & Exhibition.

Kaveh Safavi, senior managing director of healthcare at Accenture, is concerned access is going to become a much bigger issue. Though he’s hopeful that technology like generative AI could ease some of the documentation and administrative burden on providers, that future might not come soon enough.

“I actually think that tech is going to give us an answer. I’m not sure we’re going to be able to take advantage of it as quickly as we need to,” he said.

Cris Ross, chief information officer at the Mayo Clinic, said he thinks technology like ChatGPT will gain traction, but he’s not ready to unleash it yet. For one, the technology sometimes confidently spouts false information.

And he argues many health systems simply won’t be able to take advantage of the technology at all.

“I think for many, many health systems for whom their IT department is the phone call to their EHR vendor, they don’t have the wherewithal to invest in sophisticated technologies,” he said. “And it’s going to have to be the hyperscale companies that can assist them because they can do things at scale.”

Larry Leisure, founder and managing director of Chicago Pacific Founders, said the increasing cost of healthcare may soon come to a head. Employers simply can’t push costs onto their employees any more.

“For a whole swath of lower and middle income workers, they can’t afford deductibles and coinsurance,” he said. “And so this notion that we’re going to be able to do some additional cost shifting is highly problematic.”

Steven Nelson, president of Contigo Health, said the industry frequently talks about how patients are acting more like consumers, but many aren’t very engaged, only checking into their benefits at the very last minute.

“I think it’s going to be hard to refresh the consumer and get them to take concern unless they’re chronically ill and it’s that meaningful, unless they have a substance use disorder problem, unless they have a diagnosis or something with their family member,” he said. “I just think it takes something else to get everybody at the table. Even in this conference, are we really, truly engaged in our benefits to reduce that demand? I don’t know if we are.”

But Safavi argues the idea that demand for healthcare can be easily prevented is an “appealing mythology.” Many diseases are driven by genetic and social factors, and the healthcare system will struggle to address some of the nation’s biggest public health concerns, like gun violence.

“These are super complicated. It’s a combination of genetic and environmental factors that happen in certain sequences. Making good life choices may or may not work,” he said. “There are so many things that are going into it, to me it’s just harder and harder to have confidence that if you just live a good life it’s going to be enough.”

Source URL: https://www.mobihealthnews.com/news/tech-may-not-be-easy-solution-health-systems-financial-challenges

© 2024. Contigo Health, LLC. All rights reserved.

For reasons almost too numerous to count, including the most recent pandemic, substance use disorders, or SUDs, have been on a steady rise in the workplace and beyond. Whether it be the lasting effects of the pandemic or the changing family and socioeconomic dynamics facing our communities, we must look at this not as an individual problem but rather as a problem gripping us all.

70.4% of all adults with an alcohol or illicit drug use disorder are employed,¹ and 1 in 7 Americans will experience a substance use disorder.² According to one national survey in 2021, Americans’ substance use has increased 30% overall since the start of the pandemic.⁴

The numbers back this up: 70.4% of all adults with an alcohol or illicit drug use disorder are employed,¹ and 1 in 7 Americans will experience a substance use disorder.² And it’s staggering to think that 10% to 15% of those in healthcare will misuse substances during their lifetime.³

According to one national survey in 2021, Americans’ substance use has increased 30% overall since the start of the pandemic.⁴ These numbers should startle us and make us realize that reframing the conversation around substance use disorder isn’t something we need to do but rather something we have to do.

Let’s understand how SUDs are affecting the workplace.

According to the National Safety Council, the impact of substance use disorders on the workplace is considerable. Some studies place the base cost for employers to recruit and train replacement workers at a third of a worker’s annual salary, with additional costs to the employer totaling roughly half that salary when all is said and done. In some sectors with higher average salaries, this cost can be even greater.⁵

The costs for employers who have employees with untreated SUDs is also eye-opening. The annual attributable medical expenditure of a SUD diagnosis for employer-sponsored insurance was found to be $15,640 per affected enrollee and a staggering $35.3 billion in the population. Alcohol-related disorders ($10.2 billion) and opioid-related disorders ($7.3 billion) were the most costly.⁶

In addition, almost 9% of working adults have a substance use disorder, with alcohol use and cannabis use disorders being the most common. Rates of SUDs are higher in industries like construction, trucking, and mining. Industries with easy access to alcohol, like entertainment and food service, also have higher SUD rates.⁵

Changing the stigma surrounding SUDs needs to be a goal.

For far too long, society—and especially the workplace—has seen those suffering from substance use disorders as having a moral failing. The perception that this disorder is a choice needs to change. We need to look at substance use disorders not as a personal failure but as a serious health problem on par with other unmanaged chronic conditions like diabetes and COPD. This reality—long understood by SUD treatment professionals but still new to many—has to be driven home by employers. If a drug-free workplace and healthier employees are the goals, success rests firmly in the lap of employers, who must be advocates for their employees, a significant number of whom may be suffering in silence due to fear of losing their jobs.

After all, an effective policy isn’t something that just happens—it’s driven by a positive workplace culture that begins and ends with employers making employees comfortable and aware of their particular policy and its positive effects.

Together, we can all create a more accepting workplace environment.

We can all encourage each other while in the workplace to be strong advocates for our fellow employees who may need support. Seeing those who are struggling as people first—people with a treatable illness—is a step toward helping them on their road to recovery. Regardless, the emphasis should never be on judging a person or looking down on them from a moral high ground but rather on helping them seek the treatment best suited for their success.

The bottom line is that employers need a way to offer access to confidential treatment that gives employees the privacy to seek the care they need without fear of losing their jobs or wages.

At Contigo Health®, we’re helping to change the conversation around SUDs by offering a revolutionary new approach to treating them.

Changing the conversation around SUDs in the workplace is something we take very seriously at Contigo Health, and it’s why we are pioneering and building a treatment program that’s everything traditional programs have failed to be. For one, it’s discreet, allowing employees to work without having to share personal struggles with their employer in industries that don’t have mandatory drug screening, possibly motivating individuals who may not have reached out for help before.

It’s practical, allowing a person to seek care while continuing to work and live at home. And above all, it’s accepting. Our program welcomes all with open arms and gives special consideration to members of the LGBTQIA+ community and diverse populations.

So how does it work?

Immediate support is provided 24/7 from our trusted partner, Lionrock Behavioral Health, Inc., who pioneered virtual outpatient SUD treatment and continues to lead the way in virtual, in-home care. A health plan member will be referred to a licensed counselor to determine the right level of treatment.

What makes our SUD program so unique, aside from the promise of incredible support within an hour, is that our health plan members can access our revolutionary hybrid treatment plan and get residential inpatient care, outpatient care, or virtual outpatient care, depending on their individual needs. Now a person can participate in treatment virtually from home, which removes one of the biggest barriers to treatment: access. Virtual one-on-one meetings and group sessions can all be handled outside of work so the person doesn’t have to leave their family or job, causing less disruption in their lives.

Those with more complex needs—e.g., co-occurring mental health concerns, medication management, and/or a higher-severity SUD—can also access treatment through our world-class and renowned collaborator, the Hazelden Betty Ford Foundation.

Regardless of the determined pathway, what this program does differently is wrap its arms around the individual, providing not just high-quality care for a predetermined period of time but surrounding them with a team. This team will help continue treatment for however long is necessary to achieve success and maintain recovery. In other words, a person receiving treatment isn’t left to go it alone once they exit the program. This new approach to SUDs is something that hasn’t traditionally been offered by many carriers, which has often left employers with a hole in their healthcare plan and employees with untreated SUDs left wondering.

This new way of treating members is a part of our transformation of Contigo Health Centers of Excellence 360™. We’re creating a first-of-its-kind, guided comprehensive care journey. This program is the next phase in making patient care even better. The impact of substance use disorders is far-reaching. No one is untouched. But together, we can help change the conversation surrounding SUDs and combat the stigmas and preconceived notions that traditional workplaces and treatment plans have often held. Because it’s time—time we wrap our arms around those who are suffering and give them the dignity and respect that a person ailing from a true health condition deserves.

1.  Frone, M. R., L. C. Chosewood, J. C. Osborne, et al. 2022. “Workplace Supported Recovery from Substance Use Disorders: Defining the Construct, Developing a Model, and Proposing an Agenda for Future Research.” Occupational Health Science 6: 475–511. https://doi.org/10.1007/s41542-022-00123-x.

2. Centers for Disease Control and Prevention. 2022. “Stigma Reduction.” https://www.cdc.gov/stopoverdose/stigma/index.html.

3. Butler Center for Research. June 1, 2015. “Health Care Professionals: Addiction and Treatment.” https://www.hazeldenbettyford.org/research-studies/addiction-research/health-care-professionals-substance-abuse#.

4. Hazelden Betty Ford Foundation. 2021. “Americans Increasing Substance Use to Cope with Mental Strain; Parents at Highest Risk.” https://www.hazeldenbettyford.org/press-release/mental-health-index-report.

5. National Safety Council. Accessed January 12, 2023. “Implications of Drug Use for Employers.” https://www.nsc.org/work-safety/safety-topics/drugs-at-work/substances.

6. Li, M., Peterson, C., Xu, L., Mikosz, C. A., & Luo, F. “Medical costs of substance use disorders in the US employer-sponsored insurance population.” JAMA Network Open, 6(1). January 24, 2023. https://doi.org/10.1001/jamanetworkopen.2022.52378

© 2024. Contigo Health, LLC. All rights reserved.

© 2024. Contigo Health, LLC. All rights reserved.

© 2024. Contigo Health, LLC. All rights reserved.

© 2024. Contigo Health, LLC. All rights reserved.

© 2024. Contigo Health, LLC. All rights reserved.