Alcohol Screening: What We Know, What We’ve Done and What We (and Plans) Can Do

May 8, 2018 · Matt Brock

Alcohol Screening: What we Know

Unhealthy Alcohol Use Screening and Follow-up Learning Collaborative

We all know someone who has struggled with alcoholism. Now, consider this: The majority of adults who drink excessively are not dependent on alcohol. Still, their health is at risk.

A recent report from the Substance Abuse and Mental Health Services Administration (SAMHSA) reveals that in 2016, 136.7 million Americans aged 12 or older reported current use of alcohol, including 65.3 million who reported binge alcohol use and 16.3 million who reported heavy alcohol use in the past month. Furthermore, a 2014 Centers for Disease Control and Prevention (CDC) Report indicates that alcohol misuse accounts for 1 of every 10 deaths among working-age adults aged 20-64 years. Excessive use of alcohol causes an estimated 88,000 deaths and costs $249 billion a year in healthcare, insurance, lost productivity, and criminal justice-related costs. Further, it is associated with chronic illnesses like heart disease, stroke, birth defects, violence, and accidental injuries. SAMHSA has reported, however, that despite these adverse consequences and disease burden, many do not receive treatment.
Nearly 30% of our country’s population misuses alcohol. 21% of adults engage in risky or hazardous drinking—consuming more than the recommended daily, weekly, or per-occasion amounts.

Clearly, alcohol misuse is a troubling public health issue. Yet, in many exam rooms, the possibility the patient is misusing alcohol is not addressed often enough. Work conducted here at NCQA and in studies around the world, confirms—we’re not screening enough.

In fact, the CDC found only 1 in 6 adults report that their doctor or other health professional ever talked with them about alcohol use. Those disappointing results come even as the U.S. Preventive Services Task Force recommends clinicians “screen adults aged 18 and older for alcohol misuse and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse.” We must do better. And we can.

Alcohol Screening: What We’ve Done

At NCQA, we often say, “You can’t improve what you don’t measure.” How can we possibly improve, unless our progress is defined and tracked? That concept applies in a new effort to encourage screening.
With support from SAMHSA, through FEi Systems, NCQA just introduced a measure for alcohol screening. Admittedly, we did not reinvent the wheel—rather, we adapted and tested the American Medical Association provider-level measure for Unhealthy Alcohol Use: Screening and Brief Counseling. Essentially, we took a measure designed for doctors, and transformed it into one for reporting at the health plan level.
Now, the Unhealthy Alcohol Use Screening and Follow-up measure is part of the Health Effectiveness Data Information Set (HEDIS®). It is the first to evaluate unhealthy alcohol use screening and follow-up care for adults in the general health plan population. It is also one of the first HEDIS measures to be reported using electronic clinical data.

Alcohol Screening: What We (and Plans) Can Do

Our next step in this effort? NCQA is forming the Unhealthy Alcohol Use Screening and Follow-Up (ASF) Learning Collaborative. We want health plans—early adopters—to work with us to improve reporting and performance.

The ASF Learning Collaborative is an interactive opportunity to strengthen understanding of quality improvement practices in terms of this measure. It includes monthly check-ins with NCQA, bimonthly collaboration opportunities, coaching webinars with other participating health plans and in-person meetings to share experiences and best practices.
We hope these plans will see it as we do. As an exciting, life-saving opportunity that ultimately helps them reach and treat families who face the devastating effects of alcohol misuse.

Get more information ot the Collaborative’s Web page.
If you are interested in joining the Collaborative, contact our team at: alcohollearningcollaborative@ncqa.org.