Some of the nation's largest businesses are raising expectations for their health plans' approaches to problem drinking. Employers such as Marriott International, General Motors and American Express are joining with business coalitions on health in evaluating the alcohol-related services provided to employees and their families by health plans. In response to this increased employer scrutiny, health plans are taking steps to expand and strengthen their alcohol identification and treatment services.

Business and Health Care Leaders Demand Quality

Major employers and state and regional business health coalitions have joined in a nationwide approach to directly assess the quality of alcohol services of 90 health plans in 21 states this year through eValue8, an initiative sponsored by the National Business Coalition on Health (NBCH). The initiative has shown that when businesses take the lead in expecting value for their health care investments, change happens:

• Addressing alcohol effectively can show improvements and payoffs in areas such as health and productivity, similar to the gains made in such disease management programs as depression, diabetes and cardiovascular illness. Plans have been challenged to educate their primary care networks on patterns and signs of alcohol problems and techniques such as brief intervention.

Dennis White of South Central Michigan Health Alliance, a regional business
health coalition of employers covering over 4 million beneficiaries nationally

• Substance abuse is an ongoing problem in the workforce. Health care systems have not been effective in the screening and referral systems for [substance abuse] disorders.… It is important that all of the quality and financial incentives support the allocation of necessary resources to deal with these issues. A collaborative effort between employers, insurers and providers can have a significant impact on quality of care and outcomes.

Allen Daniels, chief executive officer of
health care provider Allied Behavioral Care

• We're trying to increase screening for alcohol use disorders in primary care settings and to work more closely with employee assistance programs…. We began to think, “How can we step up to the plate and be ahead of the curve?”

Mary Clare Solky of the Michigan-based Health Alliance Plan

NBCH, which represents more than 7000 employer members nationwide employing 3-4 million people, oversees the eValue8 program. The survey conducts a uniform, annual assessment of the quality of care for a range of health concerns provided by health plans. Participants in the 2003 eValue8 process include American Express, General Motors, Marriott International, the Pacific Business Group on Health, the Greater Detroit Area Health Council, the New York Business Group on Health and other state and regional business coalitions.

The coalition introduced a new focus on the quality of alcohol screening and treatment by health plans in the 2003 survey. Through questionnaires and site visits, all of the health plans were asked to provide the same information about their use of alcohol clinical practice guidelines, alcohol screening instruments, member education about alcohol problems and coordination between Employee Assistance Programs, health plans and substance abuse treatment providers. Ensuring Solutions is working with NBCH and eValue8 members to analyze the 2003 plan evaluations. Results will be reported in late 2003. An interactive map indicating which business health coalitions and health plans participated in the eValue8 survey can be viewed at www.ensuringsolutions.org.

Businesses can play a key role in bolstering treatment for employees by participating in the NBCH eValue8 initiative; working to incorporate alcohol services into doctors' care, and using The Alcohol Cost Calculator, a Web-based tool developed by Ensuring Solutions available at www.alcoholcostcalculator.org. (To learn more about the coalitions and the eValue8 process, visit the NBCH at www.nbch.org.)

Eve Raskin and Lynora Williams, July 2003

Working with policymakers, employers and concerned citizens, Ensuring Solutions to Alcohol Problems at The George Washington University Medical Center in Washington, DC, provides research-based information and tools to help curb the avoidable health care and other costs associated with alcohol use. The project works to improve access to treatment for Americans who need it. It is supported by a grant from The Pew Charitable Trusts. For more information, please visit the Ensuring Solutions Website at www.ensuringsolutions.org.