Alcohol Screening and Brief Intervention Initiative

The eValue8 process revealed opportunities for improvement in the area of screening and brief intervention (SBI) for alcohol problems. The mean eValue8 alcohol quality score was 54%. Improvement is possible, as shown by the National eValue8 benchmark score of 98%, (posted by Kaiser Permanente of Southern California).

The eValue8 score is based on these criteria:

• Local collaboration
• Common AOD clinical guidelines
• Increased screening by ERs and PCPs
• Common educational materials
• Coordination of care
• HEDIS scores

Recognizing the problem, the five leading health plans in the DC metro area, Kaiser Permanente MidAtlantic, MAMSI/United Healthcare, Aetna, CareFirst, and Cigna, have agreed to work together with local high volume emergency departments and trauma centers to increase routine alcohol screening, brief intervention and treatment. Of approximately 100 Million hospital emergency department visits per year, 15-25 million injured patients are likely to have been intoxicated within 6 hours prior to injury. Mid-Atlantic prevalence is substantial, because large percentages of the population engage in problem alcohol consumption.

Binge drinking in the last month:

• MD: 19.96%
• DC: 27.46%
• VA: 22.44%

Alcohol dependence or abuse in the last year:

• MD: 6.84%
• DC: 9.83%
• VA: 7.38%

Getting these folks identified and treated is the first step to controlling the enormous costs.

The costs are substantial. For each 500,000 members:

• 36,604 are problem drinkers
• 5,124 end in an emergency room visit
• 3,264 use a hospital stays
• $61,550,000 generated in alcohol-related health care costs
• $17,300,512 in emergency department and hospital costs

What can employers do?

1. Use eValue8 and hold plans accountable for improvement.
2. Pay for SBI in trauma centers: what gets paid for gets done!!