Technical Report Documentation Page

Executive Summary


Methods and Outcomes




Worked to establish alcohol screening and brief intervention as part of national practice guidelines for medical care:

At the national policy level, we worked to have a screening and brief intervention indicator added to the National Committee on Quality Assurance’s (NCQA) Health plan Employer Data and Information Set (HEDIS). HEDIS is nationally the most widely adopted set of performance measures that enables health care purchasers (employers and states) to compare and select their health plans. Currently in its fourth generation, HEDIS is under constant revision but contains little information about the quality of substance abuse screening, treatment, and intervention services provided by health plans. We believe that provider groups will be more motivated to require their physicians to screen and intervene if they know that they will be ranked higher by NCQA as a result.

A project is currently under way, funded by SAMHSA (Substance Abuse and Mental Health Services Administration), which convened a panel of experts called the Washington Circle who have been working on this project since June, 1998. The purpose of this panel is to develop substance abuse quality measures and present them to NCQA. Via a conference call that included our colleague Kathy Bradley, M.D., (authority on alcohol screening) we consulted with them to ensure that their proposed performance measures be chosen according to prior research on the sensitivity and specificity of these instruments. The Washington Circle was receptive to our suggestions to use the AUDIT (Alcohol Use Disorders Test) to replace the more common CAGE, because the AUDIT performs better with most populations. Dr. Rivara was invited to join the Washington Circle Group and continues to work on this issue.