National Screening, Brief Intervention, and Referral to Treatment, Addiction Technology Transfer Center

Transcription

1 National Screening, Brief Intervention, and Referral to Treatment, Addiction Technology Transfer Center Presenters: Holly Hagle, PhD Director of the National SBIRT-ATTC and Eric Goplerud, PhD Senior Vice President and Director Substance Abuse, Mental Health, and Criminal Justice Studies NORC at the University of Chicago

2 What we will cover today Goals of the webinar: Introduce and discuss the goals of the National SBIRT ATTC Define what is SBIRT at the individual and systems levels? Update on National SBIRT projects and resources Ask you what you think via polls, chat and open phone lines

3 Polls

4 National SBIRT ATTC Who are we Addiction Technology Transfer Centers funded by Substance Abuse and Mental Health Services Administration (SAMHSA)

5 What is SBIRT? SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for people with substance use disorders and those at-risk of developing them. Primary care, trauma centers, emergency departments, and other community settings provide opportunities BEFORE more severe consequences occur.

6 Goals of SBIRT To encourage healthcare providers (and other entities) to screen and provide advice or counseling to their patients who misuse alcohol or other drugs. To influence risky behavior patterns and reduce exposure to the negative consequences of misuse. To improve linkages between general community health care and specialized substance abuse providers to facilitate access to care when needed.

7 ATTC-SBIRT will address the following goals: Goal 1. Serve as the national subject matter expert and key resource for SBIRT; Goal 2. Broaden ATTC scope of implementation practices and system transformation for SBIRT through the development of an SBIRT suite of services; Goal 3. Develop strategies to expand the workforce(s) that utilize SBIRT and work to insure the consistent application of the SBIRT model to insure fidelity and sustainability.

8 National SBIRT ATTC activities Technical assistance activities Implementation and coaching Learning communities Training events Webinar series twice monthly Website on the national ATTC network site Portal to SBIRT activities across multiple sectors Registry of trainers

9 SBIRT activities continued National SBIRT needs assessment Workforce development activities Targeted to specific groups addictions professionals, doctors, nurses, social workers etc Development of Practice standards National SBIRT Advisory Board Developing a national strategic plan Helping to build sustainable business model systems and finance models

10 National SBIRT projects SAMHSA state grantees & medical residencies The BIG Initiative (Brief Intervention Group) EAP Hospital Initiative HRSA NIDA NIAAA More this is not an exhaustive list of SBIRT projects

11 What have we been up to since October?

12 ATTC Messenger

13 The SBIRT Alert

14 SBIRT at the individual level Benefits - A focus on SBIRT services for each person Use of motivational interviewing Meeting people where they are in the stages of change Positive health outcomes for those using in risky or harmful ways and help for those who need it

15 SBIRT at the systems level Benefits Patients getting the help they need when they need it Positive patient outcomes leads to better outcomes for health systems Cost-savings for systems

16 Questions

17 Levers for system change Finance, Reimbursement and Purchaser Expectations New Procedure Codes - Billing 2007 CMS Medicaid SBI Procedure Codes 2008 AMA CPT SBI Procedure Codes 2008 CMS Medicare SBI Procedure Codes 2012 CMS Medicare SBI Prevention Procedure Codes 17

18 Ambulatory, ED & Hospital SBIRT Reimbursement Supports Payer Code Description OP/ED Rate Commercial, Medicaid Commercial, Medicaid Alcohol, substance abuse structured SBI; 15 to 30min $35/$ Alcohol, substance abuse SBI > 30 min $65/$185 Medicare G0396 Alcohol, substance abuse assessment, BI; 15 to 30 min $24/$32 Medicare G0397 Alcohol, substance abuse assessment, BI > 30 min $45/$65 Medicare G0442 Prevention: Screening for alcohol misuse in adults including pregnant women once per year. (outpatient) $17 Medicare G0443 Prevention: Up to four, 15 minute, brief face-to-face behavioral counseling interventions per year for individuals who screen positive for alcohol misuse $25 Medicaid H0049 Alcohol, substance abuse screening $24 Medicaid H0050 Alcohol, substance abuse brief intervention, per 15 min $48 18

19 2012 RVUs for SBI and comparable clinical procedures (physician work + facility + malpractice) RVUs Psychotherapy, office, min Office/outpatient visit, new 20 min SBI 15 to 30 min Office/outpatient visit, new 30 min Removal of spleen, total Removal of brain abscess SBI over 30 min

20 Integrating reimbursement into electronic health records Oregon Health Sciences University EPIC

21 The BIG (Brief Intervention Group) Initiative: EAP industry-wide initiative since 2009 EAPs/MBHOs National (Aetna, VO, Optum, Chestnut, MHN, Magellan, CIGNA, Ceridian, Welllpoint/Anthem) Regional (First Sun, First Advantage, Claremont; Peer Assistance) Employer and Union-based (FOH, AFA, JPMC, UPS, Caterpillar, Northrup Grumman, 3M, Aon) Professional Associations (EAPA, EASNA, CCSW, NAADAC) Business Associations (NBGH, HBGH, NBC) Researchers and Consultants (Roman, Attridge, Burke, Jacobson, Masi) Pharmaceutical Companies (Alkermes, Reckitt-Benckiser) Federal Agencies (NIAAA, CSAT, DOL, ONDCP, DOD)

22 BIG Hospital Network BIG (Brief Intervention Group) Hospital Network Collaborative More than 200 hospitals participating TA & Training & Mutual Support Monthly calls http//hospitalsbirt.webs.com 23

23 Effective Brief Interventions For Clinical Professionals 2012 MedRespond, LLC

24 Lisa Responds to You Accusatory You seem to be drinking quite a bit. What are you saying? Do you think I m an alcoholic or something? Cause I m not. Directive We need to talk about your drinking. Why? I already answered all the questions on the form they gave me. Motivational Do you mind if we go over the results of the questionnaire you filled out? I guess not. Go ahead.

25 EBI Core Competencies

26 Please contact us with Recommendations Speakers Implementation examples

27 Open Discussion Comments Questions to us Our questions What would you like to see a National SBIRT ATTC address? Contact us: sbirt@attcnetwork.org Holly Hagle holly@ireta.org Eric Goplerud goplerud-eric@norc.org