MBGH Employer Benchmarking Survey: Addressing Pain Management in the Workplace
In October 2015, March 2016 and again in October 2017, MBGH surveyed employers on the management of pain. Results identified the most common painful conditions as back pain, musculoskeletal, headache and arthritis/joint. The most common medication classes used for treating painful conditions were antidepressants, opioids and nonsteroidal anti-inflammatory drugs (NSAIDs).
MBGH 2017 employer survey results
Managing Pain: When employers were asked how concerned they were about managing pain in their population, the majority (75%) were somewhat concerned, 21% were very concerned and only 4% not concerned at all.
Opioid Misuse: When asked their level of concern about the impact of opioid misuse in their population, 32% were very concerned, 64% were somewhat concerned and 4% were not at all concerned.
Benefit Plan Design: Thirty-two percent were likely to make benefit plan design changes for pain management in the next 12 months (18% were very likely), 25% had no plans to make such changes and 21% of respondents were not likely to take this action.
Internal Policies: Eighteen percent of respondents stated that they were likely to make changes to internal policies for pain management in the next 12 months (7% were very likely). Thirty-two percent were not likely and 29% had no plans to make changes.
Drug Treatment Programs: Employers reported the following were available to their employees
| Program |
Percent of employers offering |
| Employee assistant programs (EAP) |
100% |
| Hospital inpatient treatment |
90% |
| Outpatient treatment – low intensity |
86% |
| Outpatient treatment – high intensity |
83% |
| Outpatient treatment – low intensity |
86% |
| Behavioral health |
883% |
| Residential treatment – short term (3-6-weeks) |
79% |
| Individualized counseling |
76% |
| Group counseling |
48% |
| Residential treatment – long term (6-12 months) |
45% |
The majority of employers surveyed have incorporated evidence-based design alternatives and supplemental treatments beyond medicine alone to address pain. Some of these include:
- Restrictions on opioid prescriptions, using prior authorization and quantity limits, and more advanced utilization management rules
- Making alternative medications to opioids available
- Covering non-pharmacologic alternatives for pain such as acupuncture, chiropractic treatments and medical massage therapy, cognitive behavior therapy and yoga
- Adding coverage for abuse deterrent formulations of opioids
- Promoting an EAP program to employees and supervisors
- Offering advanced disease management programs and support for employees with questions on medications
Initiatives identified related to treating and managing pain in covered populations:
- All provide access to confidential support and substance abuse treatment for employees and family members
- Nearly 70% evaluate workplace drug policies, including drug testing (e.g. drug-free workplace policy)
- Nearly 60% include workplace policies related to controlling substance abuse
- Half offer flexible practices (return-to-work programs, adaptive ergonomic design, telecommuting) to allow employees to continue working at some level without incurring further pain-related injury
- Most allowed a person on opioids to return to work with some restrictions
- 75% trained supervisors on identifying signs of opioid impairment
Areas of opportunity identified by employers surveyed:
- The majority of employers surveyed did not require patients to see a specialist prior to being prescribed two weeks or more of opioids
- Most did not know the number of employees on paid leave who were taking an opioid
- Over 80% did not know the number of emergency room visits caused by opioid misuse
- Almost 60% did not know if they provided coverage for an opioid reversal agent (naloxone)