Magellan Reports Evidence-Based EAP Success
Magellan has a firm commitment to evidence-based practice. We routinely and systematically invest in the measurement of clinical outcomes for our various services and products. Our measurement processes give both members and providers a tangible, convenient and evidence-based method of monitoring treatment progress. “We are excited to be able to share our successful results from 2007 data demonstrating that our Employee Assistance Program (EAP) services make a measurable difference in members’ lives through improved emotional health, reduced symptoms, greater strengths and increased productivity,” said Dan McCarthy, Ph.D., chief clinical officer who oversees Magellan’s EAP product.
Background
Employee assistance programs (EAPs) can offer a range of services, such as mental health care and substance abuse programs, dependent care referrals, and legal and financial assistance. EAPs can provide a method to resolve personal problems that can affect job performance and, consequently, reduce costs. Magellan has a substantial source of proxy data regarding the efficacy of EAP counseling. Supportive data include exceptional user satisfaction as reflected on member satisfaction surveys, high EAP resolution rates and robust average session usage.
But, while proxy measures contribute to our understanding of the positive impact of EAP, these measures do not answer a fundamental question: Are EAP users improving clinically – reducing their symptoms and building on strengths? In order to answer this question, we analyzed EAP-specific outcomes data using a unique behavioral health assessment system: the SF-BH™.
The SF-BH™ Assessment System
The proprietary SF-BH™ Assessment System, introduced in 2006, is a member-centric behavioral health assessment system developed in collaboration with QualityMetric, Incorporated, a recognized authority in health status measurement. The SF-BH™ expands the scope of the SF-12® Health Survey, focusing on wellness and including new, evidence-based assessment questions that address the presence and impact of behavioral health symptoms, substance use patterns, personal strengths and the therapeutic relationship during the course of a member’s EAP care.
Through Web-based technology, the SF-BH™ Assessment reaches out directly to members and providers at critical junctures during the EAP treatment process. A survey request is sent to the member when the initial authorization for EAP services is complete, and an additional survey request is sent 45 days later, after treatment has begun. See the Summer 2006 issue of Provider Focus for further process description.
The SF-BH™ has two global composite scores; one mental health and one physical health. The Mental Composite Score (MCS) has a national mean of 50 and a standard deviation of 10. The scores range from one to 100, with higher scores reflecting more positive responses. An added benefit of this tool involves the breakout of eight scales gauging multiple aspects of physical and behavioral health. These scales include mental health, physical functioning, bodily pain, vitality, general health perception, role limitation due to physical functioning and role limitation due to social functioning.
Data Analyzed
The SF-BHTM tool was integrated into Magellan’s EAP product during July 2007. The data presented below were gathered from program initiation until December 2007, and included 964 cases with both baseline and 45-day measures. The group is composed of 65 percent females and 35 percent males. Twenty-three point one percent (23.1 percent) of the members are between the ages of 25 and 34 years. Sixty-one point five percent (61.5 percent) are within the ages of 35 to 54.
Results
Emotional and Physical Health
Emotional and physical health scores at intake and at 45-days are presented in the graph below. As the graph demonstrates, EAP participants are emotionally hurting—emotional health scores approach two standard deviations below the norm. When the tool is administered again (after counseling has begun), emotional health showed a clinically significant eight point improvement. Physical health declined slightly, but this score remained above the national norm of 50.
When reviewing the patterns between the baseline and follow-up surveys, dramatic shifts toward emotional health occurred; 76 percent of the participants showed some emotional improvement and 58 percent showed a clinically significant improvement (five+ points) between measures.
Strength
One measure built into the tool is titled “strength” and measures a member’s resiliency or ability to “bounce back.” The percent of EAP users with strong strength scores increased from 31 percent to 45 percent from intake to 45-days. Magellan’s EAP not only solves problems but builds strengths and resiliency.
Absenteeism
The EAP has a positive impact on productivity and leads to a reduction in absenteeism as well. The proportion of members with days missed at work or school decreased by 10 percent when reassessed at the follow-up measure.
Therapeutic Relationship
Providers learning of their relationship rating can intervene and improve the clinical outcomes; therefore, the strength of the provider relationship is measured as part of the SF-BH assessment. At intake, 99 percent of respondents rated their relationship with their provider as average (40 percent) or strong (59 percent), and by the 45-day follow-up survey the strength of the relationship deepened, as 74 percent rated the relationship with their EAP provider as strong.
The EAP SF-BH™ data strongly support the effectiveness of Magellan’s EAP by demonstrating measurable clinical differences in emotional health, strength and productivity. With the introduction of these innovative new programs, members receive real-time, easy-to-understand reports that enable them to participate fully in their treatment and, ultimately, affect the outcome of their care. Care managers have access to outcomes assessment information, and providers are empowered by measurable data to affect the course of outpatient care in new, timely ways. In future issues of Provider Focus we will report evidence-based practice studies from our health plan and public sector services.