Template for Large Format Poster Linda Cunningham Graphics Section, The Audio Visual Centre, University of Newcastle upon Tyne, NE2 4HH

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Screening and Brief Intervention (SBI) for
Alcohol Problems Health Plan Policies and
Payment for SBI Services
Laura L Jacobus-Kantor, PhD, Eric Goplerud, PhD,
Tracy McPherson, PhD, Delia Olufokunbi Sam, PhD
Center for Integrated Behavioral Health
Policy Department of Health Policy George
Washington University Medical Center

• The percentage of plans reporting that they will
  reimburse for SBI services using the CPT codes
  was significantly higher in 2009 than in 2008.
  In 2008, 57 of plans reported reimbursing for
  SBI services rendered by non-behavioral health
  providers, and 54 of plans reported reimbursing
  for SBI services rendered by behavioral health
  providers.

Results Collaboration With Trauma Centers and
Emergency Rooms Most health plans (77) report
working collaboratively with emergency rooms
(ERs) and/or trauma centers (TCs) to promote SBI
services. While most plans reported providing
hospitals with general guidelines for SBI ,
relatively few (20) provided hospital personnel
with any plan-sponsored training on SBI services,
and almost no plans (3) reported providing
physicians or other health care providers with
financial incentives for SBI activities. Overall,
collaboration with TCs and ERs around SBI issues
increased between 2008 and 2009. In 2008, only
40 of plans reported providing ERs/TCs with
guidelines for SBI services, and only 32
reported providing payment for SBI services
offered in the ER/TC. Plan
Reimbursement for SBI Services Most plans
reported reimbursing, or planning to reimburse,
for SBI services using the new CPT codes approved
by the American Medical Association. A slightly
higher percentage of plans reported that they
would reimburse for services rendered by
non-behavioral health providers (75) than
reported that they would reimburse for services
rendered by specialty, behavioral health
providers (66). One-third of plans (33)
reported that they did not reimburse, or plan to
reimburse, any providers using these new
codes.

• Abstract
• Background In 2009, The National Business
  Coalition on Health (NBCH) included a number of
  questions on health plan policies surrounding
  screening and brief intervention (SBI) in their
  annual survey, the eValue8 RFI. These questions
  represent a set of standards for alcohol care
  that were developed collaboratively by the
  business community, health plans, and a panel of
  substance abuse experts. By increasing awareness
  and the attention given to alcohol problems, and
  specifically on SBI for alcohol problems, NBCH
  hopes to increase the availability and quality of
  these services in a variety of settings. Methods
  Ninety United States-based health plans,
  representing over fifty million covered lives,
  responded to the 2009 eValue8 RFI. Each of these
  plans responded to a number of questions that
  detailed plan policy on SBI issues. Results Most
  plans (77) reported working directly with
  hospital or trauma centers to encourage SBI for
  alcohol problems. The most common methods used by
  plans were disseminating guidelines for SBI in
  trauma settings (62), offering payment for SBI
  services delivered in an emergency setting (60)
  and offering SBI training to trauma center
  practitioners (20). Three-quarters of plans
  (75) reported that they would reimburse for SBI
  services rendered by non- behavioral health
  providers. Additional results detailing plan
  policies for SBI services in other settings are
  also presented. Conclusions While much work
  remains to be done in this area, health plans
  have begun to adopt policies that encourage SBI
  services in a variety of settings.    
• Introduction
• Beginning in 2008, CPT codes approved by the
  American Medical Association went into effect
  that allow physicians and other health care
  providers to bill for SBI services. Since the
  introduction of these codes, the National
  Business Coalition on Health has updated its
  annual survey of commercial health plans to
  include a number of questions asking plans to
  describe their policies and coverage for SBI
  services.
• Methods
• 90 United-States-based commercial health plans,
  representing over 50 million covered lives,
  responded to the 2009 eValue8 RFI.
• eValue8
• Is a uniform, annual assessment of the quality
  of care for a range of health concerns provided
  by health plans.
• Provides a repository of benchmarking data for
  approximately 100 health plans nationally.
• Is a national standardized health plan
  evaluation process developed with input from the
  Centers for Disease Control and Prevention, the
  Agency for Healthcare Research and Quality, the
  George Washington University, and the United
  States Substance Abuse and Mental Health Services
  Administration (SAMHSA).
• Responses are authenticated by trained eValue8
  staff to ensure the validity of the information
  reported by the health plans.