Opioid ball rolling down hill Evidence shows that after seven days of opioid use, one in six individuals will become addicted. (Image: Shutterstock)

As the Senate takes up a large package of bills intended to help address the opioid crisis, attention has momentarily shifted away from the group that could do more than anyone else to end this scourge: employers who still pay to cover most of America's working-age adults.

Truly solving the opioid crisis means getting serious about tackling the broader challenges of how health care is paid for, delivered and prescribed. In fact, armed with the proper knowledge and tools, employers can use their market power to enact real change and protect workers from the risk of opioid overuse and addiction.

One of the most important pieces of leverage employers have in this fight is their role as employee benefits purchasers. As it stands, there are opportunities to pursue deeper engagements with their outside benefits advisors to design coverage plans that dramatically reduce the risk of employees getting hooked on opioids in the first place.

Despite all of the awareness around opioid overuse, 30 percent of all people in large employer plans receive an opioid prescription for musculoskeletal issues every year. That rate far exceeds what evidence suggests is appropriate. And evidence shows that after seven days of opioid use, one in six individuals will become addicted.

One of the biggest issues with the current health care model is that it drives extremely short “get in, get out” 10-minute appointments and largely unnecessary or low-evidence procedures. Doctors don't take the time to get to know patients and their unique needs; instead, they are pressured to refer patients to specialists, recommend costly procedures and overprescribe addictive opioids. Sometimes, even if a patient refuses a prescription, they will receive one anyhow — it's just that ingrained in prescribers' minds.

Offering better benefits can provide access to better care. The financial and human cost of a badly undermined primary care system is unacceptable. Wise employers integrate physical therapy specialists into their primary care options and workplace design, and they seek out organizations that utilize physical therapy upfront in triage. Evidence-based plans also ensure behavioral health isn't an afterthought, as mental health disorders are prime candidates for opioid prescription. By removing access barriers to mental health professionals — potentially even offering these services inside clinics or connecting to mental health specialists remotely — employers can expand access for their workforce.

Be sure to choose a package that supports value-based primary care, where practices usually charge a monthly, quarterly, or annual membership fee. This model is effective at prevention and dealing with acute episodes. In a well-functioning value-based system, the majority of health issues can be handled upfront in order to prevent expensive and complex medical conditions down the road. Value-based primary care also helps eliminate conflicting prescriptions and care plans.

No one running a business wants to contend with rising health care costs. Yet employers can simultaneously win the battle against skyrocketing healthcare costs and offer better benefits to their employees. Not only does this help keep opioids in check, but with benefits being more important than salary for many workers, it's critical to offer the best package in order to stay competitive. According to the Society of Human Resource Management's (SHRM) 2017 Employee Benefits Survey, nearly one-third of employers expanded their benefits packages last year. The best strategy to improve benefits is to get to know your employees and their healthcare needs and preferences.

Instead of perpetuating the health care status quo, opt instead to offer your employees a plan that includes value-based primary care, where your employees get more time with doctors, short or no office wait times, and same day appointments. Pain rarely has a quick fix; there is more likely an underlying issue such as stress, ergonomics, or lifestyle. Weaving in physical therapy, mental health support, and other evidence-based treatments contributes to a high-performing workforce. Quality and patient satisfaction go up, while costs go down. It's a win-win.

Read more about the impact of the opioid epidemic on employers:


Dave Chase is co-founder of Health Rosetta, which accelerates adoption of simple, practical, non-partisan fixes to our healthcare system. He is also the author of The Opioid Crisis Wake-up Call.

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