The business case for WIPHL
WIPHL as a solution
What employers can do

The business case for WIPHL

If you are an employer, drinking and drug abuse are your concern. Why? Because most heavy drinkers and drug users are employed full-time--67.3 percent and 57.5 percent of them respectively (NSDUH Report, Worker Substance Use, Aug. 23, 2007).

Employers pay the price of employee drinking and drug use in the form of health care premiums for related injuries and illnesses, tardiness, absenteeism, workers compensation and disability claims, turnover, and decreased productivity. Untreated alcohol problems cost American business an estimated $134 billion in lost productivity each year. (Ensuring Solutions, George Washington University Medical Center, Washington, D.C.)

Nationwide, disturbing statistics highlight the magnitude of this problem:

• Health care costs for employees who have alcohol problems are about twice as high as for the average employee. (Schneider Institute for Health Policy, Brandeis University, Substance Abuse, the Nation's Number One Health Problem, February 2001)
  
  
• Each untreated substance-abusing employee costs his or her employer an estimated $640 annually. (Center for Substance Abuse Treatment, Substance Abuse in Brief, January 1999)
  
  
• One in five employees report that their co-workers' alcohol problems caused them to fear injury, work harder, redo work, or cover for the drinker. (Mangione, New Perspectives for Worksite Alcohol Strategies, JSI Research and Training Institute, 1998)
  
  
• Heavy drinkers have higher rates of absences due to injuries and illness, unexcused absences, and job turnover. (Zhang, Worker Drug Use and Workplace Policies and Programs, 1999)
  
  
• Alcohol use is involved in 20 percent to 30 percent of all ER visits and nearly half of all such visits for trauma and injury. (CDC, Alcohol Problems Among Emergency Department Patients, 2000; MacDonald, Archives of Internal Medicine, 2004)
  
  
• In a company that employs 200 workers, employees and family members make 40 alcohol-related emergency room visits per year and 121 alcohol-related ambulatory care visits per year. (U.S. Statistical Abstracts, 2000)
  
  

All of this should be of particular concern for Wisconsin employers, given the prevalence of problem drinking and drug use in our state. One out of four Wisconsin residents engage in illicit drug or alcohol use to a degree defined as "at risk" by the National Institute on Alcohol Abuse and Alcoholism. About 6 percent of our state's residents have serious addiction problems.

Nationwide, Wisconsin regularly lands at or near the top of rankings for high-risk and heavy drinking. Diseases and accidents related to alcohol and drug abuse make it the fourth leading cause of death in our state and the fourth leading cause of hospitalization.

The economic toll: more than $5 billion each year paid by our health care, social services, and criminal justice systems--and, ultimately, by our taxpayers.

WIPHL as a solution

The evidence is in regarding the efficacy of screening, brief intervention, and referral-to-treatment (SBIRT) services provided by WIPHL, the Wisconsin Initiative to Promote Healthy Lifestyles. Numerous studies have shown that such screening is more effective than urine, breath, or other laboratory tests in identifying at-risk drinking and drug use even at the earliest stages, and that brief interventions are a beneficial and cost-effective way of helping people make positive changes.

That is why--even in an era of belt-tightening--the federal government is funding more than a dozen states nationwide to develop models to implement systemic, sustainable delivery of SBIRT services. Medical associations, government agencies, and reputable health care advocacy groups have taken a stand for SBIRT, including the American Medical Association (click here to see partial list).

SBIRT services save money for our state, which is good for Wisconsin's overall economy and business climate. A key study in Wisconsin showed that the state saves nearly $1,000 in health care and criminal justice costs for every patient receiving SBIRT services (Fleming et al, Medical Care, 2000)--and this study probably underestimates health care savings as it considered only hospitalizations and emergency room visits. In other words, providing SBIRT services costs our state less money than not providing them.

SBIRT services save money for your company. As noted, each untreated substance-abusing employee costs his or her employer an estimated $640 annually. To determine how much alcohol abuse affects your business, visit the Alcohol Cost Calculator at Ensuring Solutions. In addition to reducing alcohol and drug misuse, the Wisconsin Initiative to Promote Healthy Lifestyles is implementing SBIRT services to address a number of other health behaviors (often co-occurring with alcohol and drug use) that can affect your bottom line. One example is smoking. The tobacco cessation cost calculator provided at the America's Health Insurance Plans website shows how much businesses can save through tobacco cessation.

SBIRT is becoming part of our health care system. The American Medical Association has approved CPT codes, and a reimbursement policy will be announced by Centers for Medicare and Medicaid Services in November 2007.

What employers can do

The Wisconsin Initiative to Promote Healthy Lifestyles is working with employers to spread awareness of and demand for screening, brief intervention, and referral-to-treatment services at primary care and other settings throughout our state.

Here are a few things employers can do:

• Find out whether your company's health insurance provider/s cover screening, brief intervention, and referral-to-treatment (SBIRT) services--and if they do not, make them aware that such services are important for your employees' health and your company's success.
  
  
• Share your support for WIPHL with your political representatives.
  
  
• Let us know of your interest and your support. Please contact Richard L. Brown, MD, MPH , clinical director of the Wisconsin Initiative to Promote Healthy Lifestyles (WIPHL), to discuss possibilities for mutual support and partnership. You can reach him at rlbrown@wisc.edu, (608) 263-9090.
  
  
• Learn more! Visit various sections of this website--and, for a wealth of information about how employers can address problem drinking, visit Ensuring Solutions, an initiative based at the George Washington University Medical Center.