1. Results Alcohol Use Disorder Disease Management Program: Approximately three-quarters of plans (74%) reported having an alcohol disease management program. This is a significantly higher percentage of plans than reported offering this service in 2005 (39%, p<.00). Over half of plans (52%) reported having an alcohol disorder disease management program that addressed all members. An additional 22% of plans reported having a disease management program that focuses on select high- risk populations such as individuals with comorbid conditions or pregnant/postpartum women. Screening Tools: Most health plans (87%) recommend that primary care providers use a well-validated and highly rated tool to screen for alcohol use disorders (AUDIT/AUDIT-C, MAST/BMAST or NIAAA Screen). In 2005, only 51% of plans recommended that primary care providers use a highly rated, well-validated screening tool. Of those plans that recommend a highly rated screening tool, only 58% assess whether primary care providers are using these screening instruments. Practitioner Support:  Over half of plans (51%) notify physicians if members are identified with an alcohol use disorder.  21% of plans provide physician incentives for patient engagement in alcohol disease management programs.  14% of plans provide physicians with routine progress updates on patients in telephonic alcohol management programs. Abstract Background: Most indicators suggest that treatment for alcohol lags behind treatment for other illnesses. The National Business Coalition on Health (NBCH) is working to improve the quality of care for alcohol problems by working collaboratively with both the business community and commercial health plans to develop clear, evidence-based standards for the identification and management of these conditions. Participating health plans complete a yearly survey (eValue8) that monitors the plan’s performance against these standards. Methods: Ninety United States-based health plans, representing over 50 million covered lives, completed the eValue8 survey in 2009. Results: Although participating health plans continue to identify only a small proportion of their members as having alcohol abuse or dependence (.89%) most plans report working directly with practitioners to increase screening and treatment for alcohol problems. Results from the survey also suggest that most health plans recommend that practitioners use well- validated and highly rated screening instruments to screen for alcohol problems (87%), a significant increase since 2005, when only 51% of plans made this recommendation (p<.05). Additional results from the alcohol section of eValue8, and their changes over time, are also presented. Conclusions: While health plan identification rates for alcohol problems remain low, results from the eValue8 survey suggest that health plans are increasingly adopting policies and recommendations that encourage appropriate screening and treatment for alcohol problems. Introduction Recent estimates suggest that U.S. health care expenditures for alcohol problems (including both treatment of alcohol problems and the treatment of medical consequences of alcohol consumption) will approach $50 billion in 2009 (Center for Integrated Behavioral Health Policy, 2009). Rising health care costs associated with alcohol use, and estimates suggesting that employed adults have a higher likelihood of meeting the diagnostic criteria for alcohol abuse or dependence than adults in the general population (SAMHSA, 2007) led the National Business Coalition on Health to introduce questions focusing on alcohol identification and treatment into its annual survey of commercial health plans, the eValue8 RFI. Methods 90 United-States-based commercial health plans, representing over 50 million covered lives, responded to the 2009 eValue8 RFI. eValue8: Includes evidence-based content focused on “drivers” of health. Tracks health plan performance on a variety of clinical topics including behavioral health (alcohol & depression), chronic disease management (cardiovascular disease & diabetes), prevention (tobacco, obesity & cancer) as well as pharmaceutical management. Provides a repository of benchmarking data for approximately 100 health plans nationally. Is used by large employers such as General Motors, Marriott International, Pfizer and the University of California system to evaluate health plan performance and to guide purchasing decisions. Responses are authenticated by trained eValue8 staff to ensure the validity of the information reported by the health plans. Performance Measurement Results: Percent Identified: Health plans continue to identify only a small proportion of their membership as having an alcohol use disorder. Results from eValue8 suggest that health plans reported identifying less than 1% of their members with alcohol abuse or dependence. While the percentage of members identified with an alcohol use disorders remains low, this is a significant increase from the percentage of members identified in 2005 (.60%, p <.00). Conclusion The percentage of members identified by health plans as having an alcohol problem has increased significantly from 2003-2009. Based on the number of covered lives represented by participating plans, an additional 280,000 are being identified in 2009 compared to those identified in 2003. While this represents an impressive achievement, the vast majority of individuals with alcohol problems remain unidentified and untreated. An increasing percentage of plans report offering members access to alcohol disease management programs. These programs provide members identified with an alcohol problem with case management services and ongoing support, similar to services provided for members with other chronic conditions. Health plans report working collaboratively with physicians to recommend well- validated screening tools for alcohol problems and providing physicians with information on members identified with an alcohol problem. However, very few plans report providing physicians with regular updates on member progress once they are enrolled in the alcohol disease management program. References Center for Integrated Behavioral Health Policy (2009). Alcohol Cost Calculator for Business. Available online at: www.alcoholcostcalculator.org. Substance Abuse and Mental Health Services Administration. Office of Applied Studies. National Survey on Drug Use and Health (2007 ). [Computer file]. ICPSR23782-v2. Ann Arbor, MI: Inter-university Consortium for Political and Social Research. Health Plan Policies for Screening and Treatment of Alcohol Problems: Results from the 2009 eValue8 RFI 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