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Published: July 23, 2005
Under 1% of health plan members
are diagnosed with alcohol use disorders
MEDICAL NEWS TODAY
Less than 1 percent of health
plan members are actually diagnosed with alcoholism or related disorders,
according to data from a national performance measurement project released
today in New York City at the American Medical Association Media Briefing,
Alcohol Dependence: From Science to Solutions. Based on general
population rates, health plans should be diagnosing at least four or five
times as many members with alcohol problems.
"This project offers concrete evidence of the scale of the challenge to
improve the identification and treatment of alcohol dependence among
America's workers," said Eric Goplerud, Ph.D., director of Ensuring
Solutions to Alcohol Problems at the George Washington University Medical
Center in Washington, D.C. Researchers at Ensuring Solutions analyzed data
from the alcohol use disorders section of the 2005 eValue RFI Initiative,
which captures voluntarily reported data from more than 250 health plans
nationwide. The National Business Coalition on Health, a national membership
organization of regional employer coalitions that aims to improve health
care quality, sponsored the project.
The findings indicate that the systemic failure to address alcohol
dependence begins with a failure to adequately identify people with alcohol
problems. Although approximately 8 percent of working adults suffer from
alcohol dependence or a related condition, only about .06 percent of all
health plan members (or just 8 percent of those estimated to have the
disease) receive such a diagnosis. In comparison, health plans identify
about 40 percent of patients with depression, 65 percent of diabetics and 70
percent of those with hypertension.
The data also showed that less than half--44 percent--of members identified
as alcohol dependent attend even a single alcohol or drug treatment session
within 14 days. Only about 16 percent receive the recommended three chemical
dependency health care services in the month following diagnosis. Health
plans also are failing to reach out to members in ways that would promote
successful treatment, Dr. Goplerud said. For example, few plans are sending
educational materials, and only 17 percent are making follow-up calls to
members who miss appointments.
However, the responsibility lies not just with health plans but with
physicians, employers and others who have not treated alcohol dependence on
par with other diseases, said Dr. Goplerud, who is also a research professor
in the Department of Health Policy at the GWU School of Public Health and
Health Services.
"Imagine discovering an illness that kills about 85,000 people annually, and
then imagine that we identify only one in 20 of those people--even though we
have effective treatments that can be administered by primary care
physicians or specialists. Wouldn't there be an outcry to establish a
national approach to improving access to quality care for this disease?" he
said. "Here we have such an illness: alcoholism. Yet we accept low rates of
identification and treatment. Our approach to alcohol treatment is unlike
what we expect and demand for treatment of diabetes, high blood pressure,
asthma or virtually any other health condition."
There were some bright spots in the data, Dr. Goplerud said. Seventy-five
percent of plans require primary care physicians and behavioral health care
providers to use screening tools that have been proven effective, a number
that continues to increase. The fact that alcohol dependence treatment is
now being tracked, both through eValu8 and through accreditation programs
such as those of the National Committee for Quality Assurance (NCQA), may
raise awareness and lead to positive changes.
"The mere presence of quality measures is not enough," said Dr. Goplerud.
"With diabetes, the American Diabetes Association, the Veterans
Administration and Medicare got together to develop standards for
identification and treatment. The initial rates were not very good. But
because these large groups said they cared about it, there was tremendous
energy around increasing identification and treatment rates. For alcohol
problems, we're at a very low level but effective tools are now available.
It's time for employers and health plans to care about using them."
David Anderson
danderso@gwu.edu
202-530-2321
American Medical Association
http://www.ama-assn.org |
