Screening, Brief Intervention and Referral to Treatment (SBIRT) is an evidence-based, effective method to treat alcohol and drug misuse.
The US Preventive Services Task Force (USPSTF) grades preventive care services for patients and gave a “B” to SBIRT. The task force found that screening and brief counseling interventions effectively reduce heavy drinking episodes in adults. USPSTF study results suggest that using SBIRT adults resulted in the following:
- Reduced alcohol consumption by 3.6 drinks per week
- 12 percent fewer adults reported heavy drinking episodes
- 11 percent more adults reported drinking less than the recommended limits over a 12-month period
SBIRT is endorsed by the National Council for Community Behavioral Health Care, Department of Health & Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA).
SBIRT in Oregon
Patient-Centered Primary Care Home Program
Screening for substance use issues is required for recognition by Oregon’s Patient-Centered Primary Care Home Program. To become recognized as a primary care home, clinics must routinely assess mental health, substance use, or developmental conditions and provide treatment, referral, and care coordination. SBIRT is a vital tool for substance use screening, and the Patient-Centered Primary Care Institute can help clinics adopt the SBIRT model.
Coordinated Care Organizations
SBIRT is also part of incentive measures for Oregon’s coordinated care organizations (CCO). The first statewide CCO Learning Collaborative with the CCO Medical Directors focuses on SBIRT and the other CCO incentive measures.
A collaborative creates opportunities for peer-to-peer learning and networking, sharing information on evidence-based best practices and emerging best practices, and helping advance innovative strategies in all areas of health care transformation.
Public Health Division
The Oregon Public Health Division (PHD) is developing training to increase the use of SBIRT for adolescent well care visits.
SBIRT in Hospitals
In addition, SBIRT is one of the incentive measures for Oregon's hospitals. As part of this program hospitals are working to implement SBIRT in emergency departments throughout the state. Technical assistance on this measure is being provided by OHA and the Oregon Association of Hospital and Health Systems. Additional resources on implementing SBIRT in the ED include:
Primary Care Residency Initiative
Several SBIRT pilot projects have been implemented in Oregon. The largest and most well -known is the Oregon SBIRT Primary Care Residency Initiative, at OHSU Family Medicine. This SAMHSA-funded project focuses on teaching the SBIRT method to primary care physicians.
SBIRT Billing and Payment
The Oregon Health Authority is standardizing SBIRT billing and payment policies for all payer sources. We must take care to ensure compliance in service delivery and bill submission to different payer types (e.g. Medicare and Commercial).
SBIRT coding and billing policies and regulations are a work in progress, and varies based on payer. SBIRT is a covered benefit for all Oregon Medicaid patients and for a wide range of provider types. Under current billing policies and regulations, Oregon providers may be eligible for reimbursement for a majority of their patients.
AMH Approved Evidence-Based Screening Tools
Approved Evidence Based Practices (EBP)
Michael Oyster at 503-945-9813