Spring Brings New Policy Developments in SBIRT

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By Richard L. Brown, MD, MPH

One of the exciting aspects of serving as the WIPHL’s director has been witnessing the rapid growth and depth of support for healthcare settings to deliver behavioral screening and intervention (BSI).  In just the past few months, there has been several important policy developments regarding the recommendation and delivery of alcohol and drug screening, brief intervention and referral-to-treatment (SBIRT), both on a national and state level.

Every year, the White House and Director of the Office of National Drug Policy (also known as the “drug czar”) release an update of the nation’s strategy to address its drug problems. Chapter two of the newly-released National Drug Control Policy of 2013 is titled “Seek Early Intervention Opportunities in Healthcare” and details steps the federal government is taking to promote delivery of  SBIRT. These efforts include promoting better education for healthcare professionals, enhancing fee-for-service reimbursement for services, and updating educational resources. The document cites WIPHL and its partnerships with universities and employers as a “model public-private collaboration.”

Toward enhancing the delivery of SBIRT services, the Center for Medicare and Medicaid Services recently released a plan to update its rules on reimbursing hospitals for services delivered to Medicare patients. An exciting aspect of the plan is to require hospitals to report to Medicare the proportion of Medicare patients who have received SBIRT services and to institute strong financial incentives based on quality metric reporting. This aspect of the proposal would be implemented in 2016, which gives hospitals liberal lead time to plan how they will deliver these services.

Finally, at the state level, Wisconsin’s State Council on Alcohol and Other Drug Abuse (SCAODA) is charged with making recommendations to the Governor and legislature on preventing and addressing alcohol and drug problems in our state. SCAODA will soon consider adopting its subcommittee recommendations intended to help make BSI a routinely delivered service in primary healthcare settings, emergency departments and hospital inpatient units throughout the state. Recommendations include eliciting the support of the Governor’s Office in convening representatives of private and public healthcare  purchasers, and requiring payers to publicize fee-for-service reimbursement policies for behavioral screening and intervention.

Also at the state level, the Wisconsin Department of Health Services submitted a grant application to the US Substance Abuse and Mental Health Services Administration for approximately $8 million to continue disseminating alcohol, drug, tobacco and depression screening and intervention in primary care clinics throughout the state. The Wisconsin Primary Health Care Association (WPHCA) would be a lead organization in this project. Although WPHCA serves as an umbrella organization for Wisconsin’s federally-qualified health centers, all primary care clinics will be invited to participate. Notification of a funding decision will likely come in the early fall, and service delivery will start at some clinics by early 2014.

These exciting developments are further evidence of momentum for behavioral screening and intervention. If your clinic and hospital aren’t yet delivering BSI, they will in the future. Please contact WIPHL if you have any questions on how to get BSI started in your clinic or hospital, or on what you can do to accelerate implementation of evidence-based, cost-saving BSI in your community.

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