Managed-care employee assistance programs report success

Health Care Financing Review, Spring, 1993

Utilization rates, as well as costs, have been reduced by employee assistance programs (EAPs) employing managed care strategies, according to the results of a new study.

Although some surveyed managed-care EAPs are reporting increases in utilization rates from 1 to 30 percent, they are also reporting decreases in the cost of care ranging from 16 to 20 percent and 26 to 30 percent, according to the survey conducted among readers of Employee Assistance Program Management Letter. The Letter is produced by American Business Publishing, which publishes several industry newsletters, including The Executive Report on Managed Care.

The "preferred provider network per diem contracted rates vs. 1990 actual charges is a more than 30-percent decrease," reported one EAP professional.

Several EAPs are also reporting that relapse rates have decreased by 6-10 percent and by 16-20 percent.

Thirty-two percent of surveyed EAPS use a variety of methods to manage care, including using the EAP as a "gatekeeper," provider review, concurrent review, and precertification, the study found. However, 22 percent managed care just by using the EAP as a "gatekeeper." The remaining managed-care EAPs surveyed use different combinations of managed-care mechanisms.

A free guide, Six Successful Strategies to Implementing Managed Care Programs, is available to human resources and benefits executives, by request on company letterhead along with a stamped, self-addressed envelope with 52 cents postage to: Six Successful Managed Care Strategies, American Business Publishing, Department 11, 3100 Highway 138, Wall Township, New Jersey 07719; (908)681-1133.