Substance Abuse Treatment Access: Relationship with Integration of EAP and Specialty Behavioral Health Benefits

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