The premier solution.
Health plans can achieve the maximum savings and cost effective solutions for addressing behavioral health by positioning a New Avenues EAP as the entry point for early intervention and then use New Avenues to administer its behavioral health benefits.
With this delivery model, the organization can achieve maximum savings by reducing behavioral health claims that hit the health plan. How does this work?
- Gives employees easy access to professional resources for addressing common personal and family adjustment issues for daily living and keeps these claims outside of the health plan;
- Short term counseling costs at the EAP level are absorbed by New Avenues, and only longer term more significant behavioral health claims run through the health plan;
- Longer term professional services, psychiatric services, inpatient and specialized behavioral healthcare costs that do go through the health plan are managed for risk, quality, and effectiveness by the Care Management Staff.
- Obtain the lowest provider negotiated rates with the New Avenues – MBHN provider network selected as an approved PPO for the health plan; New Avenues has demonstrated consistently that health plan in-network claims are reduced by 35-50% off retail charges.
- New Avenues provides employees with continuity of care between their EAP and health plan with minimal disruption;
- The EAP delivery model facilitates members using in-network providers which reduces employees’ out of pocket expenses and supports the cost savings for the health plan.
- Care management staff focuses on reaching out to members with serious mental health and substance abuse conditions to improve probability of recovery and resilience, treatment adherence in order to avoid relapses, inpatient hospitalizations, ER visits, lost work time, suicide, and health complications.
- Risk management strategies include coordinating care with member’s primary care physicians, specialized protocols for ADHD testing, and case management services for persons with workplace performance issues, depression/mood disorders, autism spectrum disorders, serious mental illness or chronic substance abuse conditions.