Join us for Part 2 of our insightful podcast series dedicated to improving outcomes for those affected by substance use disorders. In this episode, we'll explore effective early intervention strategies and the essential steps for building a robust support structure. Additionally, we’ll discuss how employers can ensure compliance with Mental Health Parity laws while reducing unnecessary medical expenses that contribute to wasteful spending.

Panelists will discuss:

• Strategies for enhancing early treatment of substance use disorders to prevent progression to catastrophic care.
• Publicly available resources to help identify the most appropriate treatments and high-quality care options.
• Provisions in current carrier contracts that enable them to retain a percentage of costs as revenue, while limiting access to in-network providers.
• Understanding the Mental Health Parity laws and your obligations as a health plan provider.

This episode includes guest speakers:

Kirsten Suto Seckler, Chief Marketing & Communications Officer at Shatterproof

Danielle Capilla, JD, SVP of Compliance and Operational Strategy for Alera Group's Employee Benefits division

Lisa Kugler, Psy.D., SVP for Shatterproof’s Treatment Atlas team

Substance use disorders related to alcohol and drug addiction are having a heavy emotional and financial toll on the workplace. It’s estimated that addiction costs employers upwards of $81 billion per year and employers struggle with how to provide the correct care. Finding in-network providers is challenging and health plans are paying a significant amount in out of network fees and “Shared Savings” that the carrier then takes.

Tune into this episode of The Pulse as we examine the health plan impacts of substance abuse, including uncovering why so many facilities are not in network, what the carriers’ role is in this issue and how employers can create better strategies.

Panelists will discuss:

• The advantages and disadvantages of an addiction treatment center setting up in-network contracts.
• How the laws related to Mental Health Parity influence employers and health plan decisions.
• How claims for these services are handled when out of network and who may be winning in that negotiation.
• How employers can improve their strategy to supporting the needs of their plan members

This episode includes guest speakers:

Tim Clement, VP of Federal Government Affairs at Mental Health America.

Chris Deacon, JD, Principal/Founder VerSan Consulting

Damon Eisenbrey, Partner, Arnall Golden Gregory LLP

Kirsten Suto Seckler, Chief Marketing & Communications Officer at Shatterproof

GLP-1 medications have been a tipping point in exposing the role that PBM’s have over controlling prescription drug access and cost. Not all PBM’s are created equal and most drive what is easiest and most profitable for the PBM. It’s critical that employers play an active role in controlling their health plan strategy to support improved health outcomes and health plan investments. Tune into this episode of The Pulse as we uncover the role of the PBM in prescription drug access and costs and what employers need to do to redefine expectations and outcomes from PBMs.

Panelists will discuss:

• How a drug is approved by the FDA and if that clinically is providing the most effective approach to leverage medications.
• PBM prior authorization strategies and what appropriate expectations should be
• Why and how PBMs and Manufacturers leverage rebates to force formulary restrictions
• The opportunity for plan savings related to generic medications that are not leveraged by PBMs
• What strategies related to GLP-1 appear to be most successful in driving improved health outcomes and an ROI on health plan investments

This episode includes guest speakers:

Ge Bai, PhD, CPA.
Professor at Johns Hopkins Carey Business School and Professor of Health Management at Johns Hopkins Bloomberg School of Public Health

Dr. Jonathan Bonnet, MD, MPH, CAQSM, FAAFP, FACLM, DipABOM, DipACLM.
Associate Professor at Stanford University School of Medicine and Program Director of Medical Weight Loss at the Clinical Resource Hub Weight Management Center at the Palo Alto Veteran’s Affairs

Jennifer Perlitch RPh., MBA.
Assistant Vice President – Pharmacy at AECRx