"The whole price structure and service are built around managing mental-health claims, whereas the original model for an EAP was early identification and intervention to maximize employee productivity and effectiveness in the workplace," said Rob Kramer, lead product manager for EAP and absence management at Ceridian.

Because the EAP environment has grown so competitive, prices, which were low to begin with, have not increased in years. As a result, said David Sharar, managing director of Chestnut Health Systems, one of Claremont's partners, it is nearly impossible to provide quality services.

"The purchasers are looking at price as a primary factor," Sharar said. "They're looking at it as a commodity rather than looking at what program provides good outcomes."

Although a program that combines behavioral health service, addiction treatment, and work-life benefits for one low price per employee per month is attractive to employers at a time when benefit costs are rising steadily, the capitated pricing model has not addressed competition in the field.

As John Maynard, CEO of the Employee Assistance Professionals Association, said, as more companies entered the field over the years, prices for EAPs dropped, along with the quality of services.

"EAPs traditionally have been a strategic tool by employers to enhance the productivity of the workforce and leverage the value of human capital assets," said Maynard. But in recent years, he added, EAPs have been seen more as add-ons.

"EAPs have created the impression in employers' and brokers' minds that they're waiting for someone to call with a problem, not reaching out," Maynard said. "A good, effective system includes a way to catch a problem quickly. A program isn't functioning well if it does not have early intervention."

To address the decline in EAP quality, some providers are calling for price increases or a performance-based pricing structure where employers are charged for services they actually receive.

"EAPs have behavioral expertise in the marketplace," said Maynard. "You have to communicate and report value in ways that are meaningful for executives. You get what you pay for, and you pay for what you get."

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