Ensuring the individuals you cover routinely receive behavioral screening and intervention (BSI) in their health care settings is one strategy for cutting costs and improving employee health.
- Screening all patients in health care settings for tobacco use, excessive drinking, illicit drug use, and depression with a quick questionnaire.
- Asking further questions of patients with a positive screen to gauge the severity of their risk or problem.
- Referring patients with severe problems for specialized assistance.
- Providing on-site interventions for patients with mild to moderate risk or problems.
Here are a few ways BSI can lower costs for employers:
- About 30 percent of Wisconsin adults engage in risky and problem drinking, and most are employed full-time. Most of these individuals respond affirmatively to screening questions, and many decrease their drinking after 5 to 20 minutes of discussion and perhaps a follow-up session or phone call. The National Business Group on Health concluded that brief interventions generate a 20 percent reduction in ER visits, a 37 percent decline in hospitalizations, and nearly 50 percent decreases in car crashes and arrests. A few studies suggest that BSI is effective for drug use, as well, and most drug users are employed full-time, as well. Alcohol screening and intervention yields a return on invest (ROI) of 4 to 1 within 12 months.
- Depression screening, intervention, and referral are effective, too. When these services are delivered systematically, more depressed patients are recognized and treated effectively. Impacts include net decreases in health care costs and increases in workplace productivity. Depression screening and intervention yield an ROI of 3-to-1 over 2 years.
- BSI has been proven to improve tobacco quit rates from 3 to 6 percent. When tobacco users also reliably receive optimal intervention services, quit rates improve to over 25 percent. ROI is more delayed but even greater for tobacco services.
What can you do to ensure your employees receive these services?
BSI is recommended by the U.S. Preventive Services Task Force, the National Commission on Prevention Priorities, the National Institutes of Health, the Centers for Disease Control and Prevention, and many others.
- Make sure your benefit plan covers these services. Services should be reimbursed:
- When delivered by paraprofessionals under the supervision of credentialed providers
- When credentialed providers deliver another service at the same visit
- And are exempted from direct charges to patients.
- Ensure that BSI is provided systematically at the clinics, emergency departments and hospitals where your covered individuals are seen.
WIPHL has been working with twenty health care settings — from urban Milwaukee to small towns up north — to deliver alcohol and drug screening and intervention services. WIPHL has helped those settings expand their health care team with dedicated, cost-efficient paraprofessionals, who deliver most of the services according to research-based protocols.
These settings have screened 90,000 patients and delivered 18,000 interventions. Patients and providers are very happy with the services. Episodes of excessive drinking have decreased by over 20% — enough to generate the declines in healthcare utilization found in previous research. Regular marijuana use has decreased even more.
WIPHL has recently integrated cutting-edge depression services into primary care settings. So far 27 patients have rated our services very highly and experienced a 47 percent reduction in symptoms in 4 to 6 weeks — without any new medications.
Please join with me to make BSI a standard of care in all health care settings.