Improving Access to Screening, Brief Intervention, and Referral to Treatment in Primary Care for Adolescents: Implementation Considerations

In 2016, the Center for Health Care Strategies (CHCS) launched a learning collaborative of safety net health plans to increase access to SBIRT for adolescent Medicaid beneficiaries within primary care settings. Seven participating health plans trained 300 providers in SBIRT at more than 40 provider sites over three years. Tew and Yard reflect on the largest challenges that CHCS faced during the initiative and provide perspectives for health plans looking to implement SBIRT with primary care partners. They note that provider engagement was particularly challenging, since it is difficult for providers to set aside time for training. Many health plans also lacked access to robust data that could be used to assess training effectiveness. Tew and Yard recommend that health plans collaborate with state Medicaid agencies to create new codes for SBIRT activities, which can improve data collection and allow doctors to bill for the time they spend with patients on substance use prevention. They argue that SBIRT should be used as one key tool that contributes to broader physical-behavioral health integration.

Pamela Winkler Tew & Rachel Yard, Center for Health Care Strategies