WASHINGTON (April 17, 2008)— Responses to eValue8™, an annual survey of American health plans conducted by the National Business Coalition on Health (NBCH), indicate that 58 percent of the 150 plans surveyed will pay for substance use screening and brief intervention services (SBI). These services are defined by medical billing codes recently approved by the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS). In addition, The Office of Personnel Management (OPM) recently announced that the 5.6 million employees with Federal health insurance will also be covered for SBI services.  

Health plans that have committed to paying for screening and brief intervention (SBI), when covered under particular plan documents, include:  

• AETNA (nationwide)

• CIGNA (nationwide)

• Anthem Blue Cross and Blue Shield (Colorado, Connecticut, Indiana, Kentucky, Ohio, Maine, Missouri, Nevada, New Hampshire, Virginia, and Wisconsin)

• Blue Cross of California

• Blue Cross Blue Shield in Georgia

• Blue Cross Blue Shield of Minnesota 

• Empire Blue Cross Blue Shield in New York

• Independence Blue Cross

• HealthPlus (Michigan)

• HealthPartners (Minnesota)

eValue8™ is the nation's leading evidence-based request for information (RFI) tool used by coalitions and major employers to assess and manage the quality of their health care vendors. Ensuring Solutions to Alcohol Problems at The George Washington University Medical Center, an initiative sponsored by The Pew Charitable Trusts, works with NBCH to develop the RFI questions and analyze the data collected through eValue8™. 

“One of the purposes of the eValue8™ RFI is to communicate employer expectations to health plans,” said Eric Goplerud, PhD, director of Ensuring Solutions. “This year, health plans understood that early identification and treatment of substance use problems is important to employers. We now have evidence that the plans are stepping up to meet employer expectations.”  

“I have been pleasantly surprised by the widespread acceptance of the new SBI codes,” said Dr. Doug Moeller, a medical director with McKesson Health Solutions (a seller of medical claims auditing software). “I expected a longer ramp-up period for new services like these.”  

Screening and brief intervention is a standardized medical technique that is effective for the identification of substance use-related problems. In addition, brief intervention has proven effective in reducing alcohol use among non-dependent patients in a wide range of medical settings. Both the AMA and CMS recognized this effectiveness with their approval of new CPT® (99408 and 99409) and Medicare codes (G0396 and G0397). In addition, CMS approved two HCPCS codes in 2007 (H0049 for screening and H0050 for brief intervention) for Medicaid.

“Most Americans who engage in risky and problem substance use never receive services that could help them avoid serious health and family problems, including addiction,” said Dr. Richard L. Brown, a family physician and leader of an effort to implement SBI throughout Wisconsin. “SBI prevents more disease and injury than most routine preventive services, such as screening for high blood pressure, high cholesterol, and various cancers. Bringing SBI into the mainstream of health care will produce significant economic savings and, most importantly, improve the lives of millions of Americans.”

NOTE: For an interview with Dr. Goplerud, Dr. Moeller or Dr. Brown, please contact Susan Laine at 301-530-6231. For an interview with Andrew Webber, president and CEO of the National Business Coalition on Health, contact Cary Conway at 972-731-9242.

About the National Business Coalition on Health and eValue8: NBCH is a national, non-profit, membership organization of 60 employer-based health care coalitions, representing over 7,000 employers and 34 million employees and their dependents across the United States. NBCH and its members are dedicated to value based purchasing of health care services through the collective action of public and private purchasers. eValue8™ is a product of the National Business Coalition on Health and is the nation's leading evidence-based request for information (RFI) tool used by coalitions and major employers to assess and manage the quality of their health care vendors. For additional information, visit www.nbch.org.  

About Ensuring Solutions: Ensuring Solutions to Alcohol Problems develops authoritative, research-based information about alcohol-related problems for business leaders, policymakers, and others working to save lives and money by increasing access to treatment. Ensuring Solutions, based at The George Washington University Medical Center, was established by a grant from The Pew Charitable Trusts. For more information, go to www.ensuringsolutions.org.  

About The George Washington University Medical Center: The George Washington University Medical Center is an internationally recognized interdisciplinary academic health center that has consistently provided high-quality medical care in the Washington, DC metropolitan area for 176 years. The Medical Center comprises the School of Medicine and Health Sciences, the 11th oldest medical school in the country; the School of Public Health and Health Services, the only such school in the nation’s capital; GW Hospital, jointly owned and operated by a partnership between The George Washington University and a subsidiary of Universal Health Services, Inc.; and the GW Medical Faculty Associates, an independent faculty practice plan. For more information on GWUMC, visit www.gwumc.edu.