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APHA Scientific Session and Event Listing

Recorded presentation

Alex Hoyt, RN, MSN, Constance M. Horgan, ScD, Deborah W. Garnick, ScD, and Elizabeth L. Merrick, PhD. Schneider Institute for Health Policy, Brandeis University, 415 South St, Mailstop 035, Waltham, MA 02454, 781.736.8163, ahoyt@brandeis.edu

Primary care practitioners (PCPs) can play an important role in improving the detection and treatment of substance-use conditions. One way to advance screening is to have health plans require it and monitor the performance of primary care practitioners. Here we explore the substance-use screening requirements that health plans placed on PCPs in 1999 and in 2003 and the plan's activities in monitoring performance. We conducted two rounds of a nationally representative survey of over 400 commercial health plans in 1999 (92% response rate) and 2003 (83% response rate) regarding both clinical and administrative aspects of behavioral health services. Respondents were asked about screening requirements, if screening in primary care was monitored, and if a system was in place to report the results of screening. One third of products had a substance-use screening requirement for PCPs in 2003 – an improvement from the 29% that had a requirement in 1999. Among those products that required screening, approximately two-thirds do not monitor to see if screening is done by PCPs. Moreover, there was notable incongruence between products' screening requirements and monitoring. Among those products that monitor screening, about half do so with all PCPs. The majority of health plan products that monitor to see if screening is done by PCPs have a system to report the results of screening to clinicians or to quality improvement committees. Most health plans do not require or monitor screening in primary care, representing a missed opportunity to improve the detection and treatment of substance-use conditions.

Learning Objectives:

• Recognize the role primary care providers can play in improving the detection and treatment of substance-use conditions.
• Describe the prevalence of health plans’ substance use screening requirements and monitoring in primary care.
• Analyze opportunities to improve substance use screening in primary care.

Keywords: Primary Care, Substance Abuse

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation