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Screening for alcohol problems in private US health plans
Methods. Data are from the third round of a nationally representative, in-depth telephone survey of executives at private US health plans in 2010 (89% response rate). For each of the three most commonly purchased insurance products, respondents reported on screening for alcohol problems using specific screening instruments (e.g., AUDIT) or general screening tools; screening, brief intervention and treatment (SBIRT) for alcohol problems; billing for SBIRT; and the inclusion of alcohol screening in disease management programs. Results are weighted to provide national estimates.
Results. In 2010, 18% of products required screening for alcohol problems in primary care using general questionnaires and 15% required alcohol screening using specific instruments. In 2010, 96% of products encouraged SBIRT. Moreover, along with this encouragement, 72% of products permitted primary care providers to bill for substance abuse screening and brief intervention. About two-thirds of products included routine screening for alcohol within their diabetes and congestive heart failure disease management programs.
Conclusions. Although screening is an effective way to improve the identification of those with alcohol problems, the majority of health plans still do not require screening in primary care. Because this survey was focused on health plan activities regarding alcohol screening, these results do not reveal the actual level of screening in primary care.
Learning Objectives:
Describe private health plans’ efforts to promote screening for alcohol problems in primary care.
Keywords: Alcohol Problems, Screening
Qualified on the content I am responsible for because: As relates to the specific topic of screening for alcohol problems, I have been a co-investigator on three rounds of a nationally representative survey of private health plans' provision of behavioral health services and an author on two papers on screening based on earlier survey rounds. More generally, working with teams at the Institute for Behavioral Health at Brandeis University, my research has been focused on quality and performance measurement for substance use disorders.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.