Employee assistance programs (EAPs) have been around for a long time and are viewed by many as “just a counseling service” for the addicted and deeply troubled – one that constitutes a necessary but not particularly valuable item on a company’s benefit checklist. This perspective devalues the EAP, often resulting in underutilization that diminishes the organization’s return on its investment.
Today’s changing workforce presents new challenges, so it’s important to realign employee assistance with a viable population health strategy.
This article examines four key initiatives that can optimize the value of your EAP, as well as properly integrate it with related benefit offerings.
1. Service Delivery Options
Historically, access to EAP services has been provided telephonically using a triage-based call center with referrals into a local network for face-to-face assessment and counseling. However, utilization data indicates that only about 50% of callers actually schedule and attend face-to-face sessions offered through the EAP. Many reasons can account for this, including:
- Wait times for appointments
- Competing life priorities (time constraints)
- Scheduling conflicts
- Driving times
- Second thoughts about seeing a counselor and having to tell one’s story to yet another stranger
- Concerns about confidentiality
- The overall “hassle factor”
To address these concerns, some EAPs are providing multiple portals for accessing and utilizing services. For example, telephonic counseling sessions, once regarded as taboo in the EAP field, are now favored by many program users as a way to avoid driving times to appointments and other logistical hassles, as well as the stigma of potentially being seen in a counselor’s office. This industry bias against telephonic counseling has been undermined by studies showing that behavioral outcomes from this modality of care are as good or better than with in-person sessions. With advances in technology and encryption, secure video counseling and real-time chat are now viable options for the delivery of EAP services, as well.
Self-serve options provided through an EAP’s website have also proven an effective method to obtain assistance with a wide range of life’s challenges. Validated self-assessment instruments, legal forms, financial calculators, child- and elder-care locators, educational videos, moderated chat communities and online support groups are just a few of the options for employees and family members. By promoting your EAP’s website as part of an employee communication strategy, you educate potential users about the scope of services, as well as the variety of access portals from which they can choose. The result? Greater return on your investment in the EAP and enhanced well-being among those employees/family members using the service.
Challenge to your EAP: What are the different modes of access you offer my employees and their family members? How are your services delivered? How do my workers and their families know that these options exist?
2. Measurable Outcomes
Until recently, the employee assistance industry has attempted to show value by focusing on utilization rates and user satisfaction scores. To address employer dissatisfaction with penetration rates of 2-6%, some EAPs expanded the definition of utilization to include website hits and the number of attendees at brown bag seminars or health fairs. The true value of any workplace program rests not only with how many people use it but, more importantly, with the impact of the service on their well-being and job performance. In 2010, to measure the impact of EAP services, the behavioral science research firm Chestnut Global Partners developed, validated and distributed an instrument called the Workplace Outcomes Suite. EAPs using this instrument as a standard of practice are now publishing positive results indicating that employees who engage with the EAP have lower absenteeism rates, higher levels of engagement, increased life satisfaction and reduced presenteeism. Now we’re getting somewhere.
Challenge to your EAP: How are you measuring behavioral outcomes resulting from your services? What, if any, instrument are you using to do this, and is it scientifically validated? Can you show me outcome data specific to my employee population?
3. True Benefits Integration
As companies have attempted to implement an overarching wellness strategy, vendor summits have become more popular. Representatives of all the organization’s benefits vendors meet and share details of their particular programs and commit to making cross-referrals to improve the overall health and well-being of members. Typically, despite the best of intentions, there is an initial flurry of activity that often trails off until the next summit. To generate the value that genuine integration can bring, it’s critical that each benefit vendor be aware of the offerings of all the other programs your organization has in place, and make appropriate cross-referrals to meet the needs of individual members.
For example, there are a lot of details to address for an employee who is pregnant with her first child. She probably will call her health insurance carrier to find out what the plan covers for prenatal care and delivery. With true benefit integration, the insurance carrier’s representative would answer her coverage questions but also remind the employee of the maternity management program and the work/life services available through the EAP that assist in evaluating child-care options. If established protocols are in place among the various vendors, a warm transfer can be offered and completed. The counselor can review the other ways the program can support the employee and her family, as well as remind her of the 24/7/ availability of services. With her permission, the EAP can schedule a call a month after delivery to see how she is handling the changes in her life and to review child care plans.
The employee gets the information she needs but is also made more aware of all the programs in place to support her through her pregnancy and beyond. The employer’s value comes in knowing that each vendor partner is looking at every caller through a more comprehensive lens, one that can save the employee time and consternation, as well as increase utilization of the programs the company is already paying for. In addition to utilization and outcomes data, your partners should also be prepared to report the number, type and results of referrals made to other benefit programs.
True integration is even more critical for addressing co-morbid psychosocial issues often seen in tandem with chronic medical disease. For instance, a depressed diabetic is four times costlier to treat than one with no mental health issues. If your health and wellness providers are focused solely on treating the primary disease, the opportunity to improve a member’s overall well-being while also lowering the company’s health care costs is lost.
Challenge to your EAP: What is your protocol for expediting referrals to and from your other benefit programs? What type of reporting can you provide to confirm that true integration is being achieved?
4. Culture of Health
The agenda of many wellness programs remains focused on encouraging members to exercise more, eat less and participate in preventive screenings. These and similar initiatives are important steps for improving physical health and wellness, but what about the behavioral culture that employees live and work in much of the day? According to a 2010 Buck Consultants survey, one of the fastest growing wellness program components in Africa, Asia, Europe and Latin America is a focus on “improving the psychosocial work environment.” In his book Zero Trends: Health as a Serious Economic Strategy, University of Michigan professor Dee W. Edington states, “the psychosocial environment may be one of the real growth areas in the future as we learn more about ways to motivate and reward individuals through the culture of their organization.”
EAP practitioners have long recognized that the psychosocial environment of the workplace has a powerful impact on an individual’s overall health and well-being and, ultimately, a company’s health care spending. Healthy choices in the vending machines and a walking program both are worthwhile, but so is teaching conflict resolution and enhancing the emotional intelligence of front-line and middle managers. Your EAP understands the impact of behavioral dynamics and their collective influence on individual behavior, yet it is often an untapped resource in the quest to create a culture of health.
Challenge to your EAP: Can you help us assess the “behavioral landscape” of your workplace culture and how it influences workforce health and well-being? What programs do you offer that address behavioral issues that may be impeding movement toward a culture of health? What can you do to help us improve our psychosocial environment?
Challenging your EAP will help you determine if the program is “just a counseling service” or if it can serve as a critical component of your overall health strategy. All EAPs are not created equal. Do a good assessment of the health and psychosocial needs of your population, ask some pointed questions of your benefit partners and hold them accountable. It will make a positive difference.
Reproduced with permission from Benefits Magazine, Volume 50 Number 3, pages 32-35 March, 2013, published by the International Foundation of Employee Benefit Plans (www.ifebp.org), Brookfield, Wisconsin. All rights reserved. Statements or opinions expressed in this article are those of the author and do not necessarily represent the views or positions of the International Foundation, its officers, directors or staff. No further transmission or electronic distribution of this material is permitted. Subscriptions are available (www.ifebp.org/subscriptions).