Back to Annual Meeting

Back to Annual Meeting

Abstract #160860

Elizabeth L. Merrick, PhD¹, Constance M. Horgan, ScD¹, Dominic Hodgkin, PhD¹, Vanessa Azzone, PhD², Frank Holt, RN, BSN¹, Bernie McCann, MS, CEAP¹, and Sharon Reif, PhD¹. (1) Institute for Behavioral Health, Schneider Institutes, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Mailstop 035, Waltham, MA 02454-9110, 781 736 3917, merrick@brandeis.edu, (2) Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115

Facilitating substance abuse treatment access and engagement is critical because alcohol and other drug disorders are frequently not addressed despite availability of effective treatment. Specialty behavioral health benefits can be offered separately, or integrated with employee assistance program (EAP) benefits; both are common in the private sector. Yet, the impact of including EAP access together with other behavioral health benefits on substance abuse treatment utilization is not well understood. We analyzed insurance claims and other data for 2004 from a national managed behavioral health care organization including 5.1 million privately insured enrollees. Bivariate analyses comparing the two benefit approaches showed that while the proportion of enrollees with any behavioral health claims was significantly higher in the integrated arrangement (5.2% versus 3.7%), the proportion accessing substance abuse services was similar in both (0.2%-0.3% depending on service definition). We also examine and contrast treatment engagement and utilization patterns in each benefit approach for the approximately 14,000 individuals who received any substance abuse services. Multivariate models examined the effects of benefit approach in the context of variables from other key domains including individual-level characteristics, employer and provider characteristics, utilization management procedures, and consumer cost sharing. Findings suggest that factors including benefit approach may affect substance abuse treatment access and utilization differently than behavioral health overall. Results will help to inform practitioners, employers, insurers, policymakers, consumers and others con

Learning Objectives:

• Describe behavioral health access within integrated EAP/behavioral health versus separate benefit models in a leading national behavioral healthcare organization.
• Identify significant factors, including integrated benefits, in substance abuse treatment access and utilization.
• Explain implications for service systems and service delivery.

Keywords: Managed Care, Substance Abuse

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.