The Surprising Role of Comorbidity In Chronic Disease Cost

Most people wouldn’t be surprised to hear that chronic health conditions such as diabetes, heart disease, obesity, arthritis and cancer are major drivers of healthcare cost for employers. What may be a surprise is how frequently those chronic physical health conditions are comorbid with mental health disorders. In a nationally representative epidemiological survey 29% of those with a medical disorder were found to have a comorbid mental health condition. Conversely, more than 68% of adults with a mental health disorder reported having at least one general medical disorder.

The Impact of Comorbidity

Various studies have shown that addressing mental health conditions in comorbid cases can reduce the severity and duration of co-existing physical health conditions.

The presence of mental health conditions significantly affects the cost of care for comorbid physical conditions. Consider diabetes, a very relevant example considering more than 100 million American adults are now living with diabetes or prediabetes according to the CDC. Studies have shown that healthcare expenditures for patients with diabetes and depression are 2 to 4.5 times as high as those of patients without depression. .According to one study, the coexistence of depression and diabetes is associated with increased mortality and morbidity, including higher rates of complications, increased disability and lost productivity, lower quality of life, and increased risk of death.

In a recent Open Minds Daily Executive Briefing newsletter, Sarah Threnhauser described the costs incurred for patients with comorbid depression and chronic physical conditions compared those with the physical conditions alone. Her findings indicated:

  • The cost of care for heart failure was 29% higher when the consumer also had depression
  • The cost of care for coexisting rheumatoid arthritis and depression are 7.2% higher than RA alone.The cost of care for coexisting osteoarthritis and depression are 38.8% higher than OA alone.
  • Those with cancer and depression had total annual healthcare expenses 113% higher than those with cancer alone.

Threnhauser also noted how frequently some chronic physical health conditions occur with mental health conditions.

  • 43% of consumers with depression are obese. Obesity and depression form a vicious cycle. Obesity makes it more likely that a person becomes depressed and depression make in more likely that a person becomes obese.
  • In a national sample of adults with diabetes almost 33% of the survey sample of US adults with diabetes had either unrecognized depression, asymptomatic or symptomatic depression

A Proactive Solution For Employers

Recognizing the high and growing cost of chronic disease and the impact of comorbidity on costs and treatment, Espyr has developed an innovative solution called Spotlight. Spotlight enables employers to proactively identify and provide behavioral health coaching to employees with comorbid mental and physical health conditions.

Spotlight is a behavioral health coaching product supported by a rich data set. Using a proprietary algorithm, Spotlight identifies those employees who are at highest risk of driving healthcare expenses and who are most likely to engage with interventions. Once employees are identified, they are connected with the appropriate behavioral health coach from Espyr’s national network of behavioral health professionals. Interventions could include:

  • Behavioral health coaching
  • Stress, depression and anxiety support
  • Relationship support and coaching
  • Financial consultation

Spotlight enables employers to focus their healthcare dollars where they can have the greatest return on investment. Plus, the rich data set supporting Spotlight improves the efficacy of Espyr’s behavioral health coaches, which in turn will lead to more successful outcomes.

Learn More

To learn more about Spotlight and other Espyr products that enable employers to proactively reduce healthcare expenses and increase productivity, call Espyr at 888-570-3479.


How To Manage Rising Employee Anxiety and Depression

A multitude of recent studies tell us that anxiety and depression are markedly higher now than in earlier eras.

For employers, the most common tool provided to employees suffering from anxiety, depression and other mental health issues is the Employee Assistance Program (EAP). EAPs have become almost universal in mid sized or larger American companies. According to the Bureau of Labor Statistics, 85% of US businesses with 500 employees or more offered access to an EAP. Within larger companies, those with more than 5,000 employees, the percentage gets even larger with 97% reporting that they offer EAP access to their employees.

Yet, one of the most common complaints about EAPs is that they don’t get used. In fact, average utilization rates range from 4.5% to 6.5%.

The need for behavioral health solutions has never been greater

Stress and anxiety are increasing in workersAs the need for mental health solutions grows, one would expect EAPs to be used more frequently. Why isn’t that happening? Most experts point to several factors.

  1. There is still a stigma attached with mental health conditions.   For most people with a physical ailment, seeking help from a professional such as a doctor is the smart, socially acceptable response. However, ask that same person whether they’d seek professional help for a mental health condition and you’re liable to see a very different reaction. The stigma of mental health is still a very significant barrier for those needing treatment.
  2. There is concern for confidentiality. Could asking for help become noted in your personal file? Could it impact promotion opportunities? What if fellow employees learn about it? These are all understandable questions, and in some cases justifiable concerns.
  3. Despite the high prevalence, employee awareness of EAPs is often low, and awareness of the breadth of EAP support services offered is even lower.  Lack of awareness may be partially attributed to broker or insurance carrier provided EAPs – the free EAP – thrown in to sweeten a benefits package. Free EAPs may sound good, but in order to turn a profit a free EAP provider has to minimize utilization and reduce services. That means limited or no marketing to build awareness, limited management reporting, no on – site services or face-to-face sessions and a reduced level of support when employees call for help.

Organizations still need an EAP

This is not to say that EAPs don’t have value. They do, and most employers need to provide employees the services that an EAP can deliver.

Furthermore, there are many ways to increase EAP utilization rates and stand alone EAPs like those offered by companies like Espyr achieve much higher utilization than the average EAP.

Nonetheless, EAPs are reactive tools. They work only when employees engage. When employees don’t use the mental health services offered by their EAP the implications can be costly for both employers and employees.

Is there a better solution?

Sensing that something different was needed, behavioral health companies like Espyr have focused on new product innovation to address the growing need for more effective mental health solutions. Pilots are high stress occupationsHigh stress occupations in particular, like first responders, the military, airline pilots, healthcare, teachers and business executives are needy targets for such new solutions.

At Espyr, the need for an innovative solution resulted in the development of a new offering called Spotlight™. Rather than hope that employees with mental health issues step forward and ask for help, Spotlight uses big data analytics to proactively identify those employees posing the highest potential healthcare expense risk. Spotlight then cross-references expense risk with a proprietary tool that indicates likelihood to engage. The output enables employers to not only proactively address those posing the greatest expense risk, but empowers them to efficiently target those employees most likely to accept help.

Finally, Espyr connects those targeted employees with professionally trained, master’s degreed coaches from its national network of behavioral health professionals to create individualized solutions.

Mental health conditions and physical health issues frequently co-exist

Spotlight gets help to the employees that need it most while reducing productivity losses and absenteeism for employers. Furthermore, there is increasing recognition of the co- existence of mental health and physical health conditions.   This co-existence means that effectively addressing physical health conditions often requires addressing underlying mental health disorders. Failing to do so can lead to escalating healthcare outlays to treat chronic health conditions.

To learn more about Spotlight and see how it might help your organization, call us at 866-570-3479 or go to

Workplace Drug Use: Think It’s Not A Problem For You?

If today’s employers are finding that employee engagement is especially low, it may be because some of their employees are high. A new study released this summer by Quest Diagnostics, a provider of diagnostic information services, reveals that workplace drug use is the highest it’s been in more than a decade.

While prescription opioid rates have declined sharply across the nation, the on-the-job use of cocaine, amphetamines and marijuana has risen sharply, especially in certain regions. Here are a few specific findings from the Quest Diagnostics study:

  • Cocaine use has increased for the fifth consecutive year, including double-digit year-over-year increases in Nebraska, Idea, Washington, Nevada, Maryland and Wisconsin.
  • Between 2013 and 2017, methamphetamine use has increased 167% in parts of the Midwest, 160% in parts of the South, 150% in areas of the Northeast and 140% in the Southwest.

If you still think drug use has yet to reach your employees, consider these disturbing stats from the National Council on Alcoholism and Drug Dependence:

  • 70% of the estimated 14.8 million Americans who use illegal drugs are employed.
  • Of those 70%, more than 42% admit that their work productivity suffers due to their use.

“The significant drop in opiate use is a promising sign,” said Matt Nieman, General Counsel, Institute for a Drug-Free Workplace. “Yet, the ten-year high rates serves as a stark warning that efforts to prevent substance abuse in the workplace are as important today as ever.”

The Opioid Problem is Not Over

The drop in opioid use doesn’t mean the opioid problem has gone away. Opioid prescriptions have nearly quadrupled since 1999, according to the Centers for Disease Control and Prevention. While the drugs legitimately help people manage pain, they are also still very addictive. The National Institute on Drug Abuse provides plenty of scary facts to illustrate our point:

  • Roughly 21 to 29% of patients prescribed opioids for chronic pain misuse them.
  • Between 8 and 12% develop an opioid use disorder.
  • An estimated 4 to 6% who misuse prescription opioids transition to heroin.
  • Every day, more than 115 people in the United States die after overdosing on opioids.

Drug Use is Expensive, Too

These trends aren’t just disturbing on a human level. They’re costing employers – and society at large – a lot of money. Crain’s Detroit Business points out that, in 2013, opioid abuse alone cost businesses $16.3 billion just in disability claims and lowered productivity.

Tess Benham, of the National Safety Council, reminds us there’s also a high cost in absenteeism. Where the average worker misses about ten days per year, those abusing pain medication or using heroin miss an average of 29 days of work per year.

When you consider the combination of lowered productivity, higher health care, substance abuse treatment costs and missed work, you have a total economic burden of $78.5 billion, according to the National Center for Injury Prevention and Control. Curtis S. Florence, who led the research, adds, “And that’s definitely a conservative estimate.”

What Can Employers Do to Help?

Common sense says that employers need to be part of the solution. First, however, they need to admit there’s a problem. In a survey by the National Safety Council, seven in ten employers reported on-the-job drug abuse issues ranging from absenteeism to overdose. Yet, only 24% said it was an issue.

The National Council on Alcoholism and Drug Dependence  has some clear, practical advice for employers, all centered on encouraging and supporting treatment. Here are some specific ways they say employers can address substance use and abuse in the workplace:

  • Implement a drug-free workplace and other substance abuse policies.
  • Offer health benefits that provide comprehensive coverage for substance use disorders, including aftercare and counseling.
  • Reduce the stigma of getting help through education and communication. You can read more about steps we’ve seen work in this blog on Reducing The Stigma Of Mental Health.
  • Educate employees about the health and productivity hazards of substance abuse through company wellness programs.

While all these policies and programs will help, the NCADD has one strong recommendation. “ “Without question, establishment of an Employee Assistance Program (EAP) is the most effective way to address alcohol and drug problems in the workplace,” says the NCADD. “EAPs deal with all kinds of problems and provide short-term counseling, assessment and referrals for employees with alcohol and drug abuse problems.”

At Espyr, we also understand the power of EAPs. But as a leading behavioral health company we’re continuously innovating to find new solutions to behavioral health issues. For example, we’re leading the way with a suite of coaching programs to encourage employees to ask for help when they need it or when traditional counseling isn’t required. We’ve developed innovative new approaches like Spotlight™, a behavioral health coaching and proprietary data analytics platform. Spotlight is able to proactively identify and aid employees (and their dependents) that may need assistance with drug abuse and other healthcare issues. It can more than pay for itself in reduced absenteeism, increased employee engagement, increased employee retention and a reduction in healthcare costs of up to 20%.

Espyr is offering Spotlight with partners such as Fairbanks Employer Services, one of the oldest and most highly regarded alcohol and drug treatment centers in America. With this new marketing partnership, Fairbanks will offer this technology to their portfolio of client companies under the name Fairbanks Spotlight™.

For more information on how Espyr can help you achieve a drug-free work environment, call Espyr at 866-570-3479 or go to


Espyr® Announces Major Marketing Partnership with Fairbanks

Partnership To Bring Next Generation Behavioral Health Management Program To Fairbanks Employer Relationships

Espyr, the leading behavioral health company developing innovative solutions for maximizing human and organizational potential, and Fairbanks, one of the oldest and most highly regarded alcohol and drug treatment centers in America, have agreed on a marketing partnership where Fairbanks Employer Services will help market Espyr’s Spotlight™ to Fairbanks’ portfolio of client companies. The product will be marketing under the name Fairbanks Spotlight™.

Spotlight is a state-of-the-art behavioral health management program specifically designed for self-insured employer groups of 500 or more. Using proactive behavioral health coaching and proprietary data analytics, Spotlight is able to identify and aid employees and their dependents that may need assistance.

Spotlight can reduce healthcare costs by up to 20%

Spotlight is a totally new and innovative approach to Behavioral Health. Spotlight’s impressive benefits more than pay for itself: reduced absenteeism, increased employee engagement, increased employee retention and a reduction in healthcare costs by up to 20%.  To learn more about Spotlight click here.

In announcing the partnership, Espyr CEO Rick Taweel stated, “ We are delighted to be partnering with such a well respected and successful organization as Fairbanks. Fairbanks recognized the benefit of using Spotlight to identify and address behavioral health issues in treating, and more importantly, preventing substance abuse problems. Spotlight is a perfect complement to the services they already provide to their many employer relationships.“

To learn more go to Fairbanks Employer Services.