Although the new mental health parity mandate may increase plan costs somewhat, sponsors can mitigate increases through changes in plan design and medical management practices. The new law allows the use of medical management tools that are based on valid medical evidence and are pertinent to the patient’s medical condition. One such tool is a Member Assistance Program (MAP).
MAPs embody a proactive, health care management approach that ensures quality care while providing savings and economic stability for both the union and employers. They serve as a “benefits gateway” to avoid unnecessary treatment costs for substance abuse and mental health-related conditions, and they typically use cost-effective out-patient treatment or community services, helping to keep workers “on the job” while their problems are addressed. Indeed, many cases are resolved for free before even getting to the healthcare fund. The small number of participants who require costly in-patient treatment are referred to facilities that offer quality service at reduced fees, as in preferred provider organization (PPO) arrangements. Individual case management by the MAP monitors the treatment and recovery progress, enabling use of less costly services as early as possible. Post-treatment monitoring and aftercare also reduce relapse rates.
Plan participants and their dependents receiving help through a MAP for substance abuse and related conditions file fewer and less expensive health insurance claims.
When members bring problems to their union representative, the MAP provides a ready referral for professional help. Providing MAP services is a reminder that the union cares about members and their families.
For LIUNA signatory employers, the availability of MAP services reduces the chance that personal concerns will negatively affect job performance. MAPs foster declines in absences and tardiness while providing a means for a good worker to get help for a problem before it becomes an on-the-job impediment. In addition, MAP services remove the employer from the position of either ignoring an employee’s personal problem or trying to diagnose and resolve it, a task for which most employers are not qualified. It also provides a means to fulfill obligations of the Drug-Free Workplace Act and other government substance abuse regulations. MAP services help reduce workplace accidents and contriubte to increased productivity. Employers can expect to file fewer accident reports, reduce workers’ compensation claims and see fewer grievances.
The ultimate beneficiaries of a MAP are plan participants and their dependents. They have 24/7 access to professional and confidential assistance for personal concerns. Part of the service is counseling to ensure that the recommended treatment fits their budget, schedule and other needs.
LIUNA was the first union to adopt MAPs, and many of its health and welfare funds have extensive experience with their costs and benefits. The adoption of mental health parity and addiction equity as the law of the land makes their role all the more prominent, pertinent and valuable. Any health and welfare fund without a MAP should look closely into starting one. For more information, contact the LHSFNA Health Promotion Division at 202-628-5465.
[Steve Clark with Jamie Becker]