Sustaining SBIRT in the wild: simulating revenues and costs for Screening, Brief Intervention and Referral to Treatment programs.
Aims To examine the conditions under which Screening, Brief Intervention and Referral to Treatment (SBIRT) programs can be sustained by health insurance payments. Design A mathematical model was used to estimate the number of patients needed for revenues to exceed costs. Setting Three medical settin...
| Publicado en: | Addiction Vol. 112; pp. 101 - 110 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Feb2017 Supplement
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=120660168&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 120660168 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Feb2017 Supplement vid: 112 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 120660168 120660168 120660168 10.1111/add.13650 120660168 ppf: 101 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Sustaining SBIRT in the wild: simulating revenues and costs for Screening, Brief Intervention and Referral to Treatment programs. aug: au: Cowell, Alexander J. Dowd, William N. Mills, Michael J. Hinde, Jesse M. Bray, Jeremy W. affil: RTI International, Research Triangle Park, NC, USA sug: subj: Substance Abuse Therapy Substance Abuse Diagnosis Treatment Duration Health Screening Referral and Consultation Simulations Health Services Methods Health Services Economics Program Evaluation Multicenter Studies Models, Statistical Mathematics Substance Abuse and Mental Health Services Administration Insurance, Health, Reimbursement Emergency Service Outpatient Service Inpatients California Texas Alaska Illinois New Mexico Pennsylvania Washington Male Female Adolescence Adult Middle Age Medicaid Insurance Coverage Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Aims To examine the conditions under which Screening, Brief Intervention and Referral to Treatment (SBIRT) programs can be sustained by health insurance payments. Design A mathematical model was used to estimate the number of patients needed for revenues to exceed costs. Setting Three medical settings in the United States were examined: in-patient, out-patient and emergency department. Components of SBIRT were delivered by combinations of health-care practitioners (generalists) and behavioral health specialists. Participants Practitioners in seven SBIRT programs who received grants from the US Substance Abuse and Mental Health Services Administration (SAMHSA). Measurements Program costs and revenues were measured using data from grantees. Patient flows were measured from administrative data and adjusted with prevalence and screening estimates from the literature. Findings SBIRT can be sustained through health insurance reimbursement in out-patient and emergency department settings in most staffing mixes. To sustain SBIRT in in-patient programs, a patient flow larger than the national average may be needed; if that flow is achieved, the range of screens required to maintain a surplus is narrow. Sensitivity analyses suggest that the results are very sensitive to changes in the proportion of insured patients. Conclusions Screening, Brief Intervention and Referral to Treatment programs in the United States can be sustained by health insurance payments under a variety of staffing models. Screening, Brief Intervention and Referral to Treatment programs can be sustained only in an in-patient setting with above-average patient flow (more than 2500 screens). Screening, Brief Intervention and Referral to Treatment programs in out-patient and emergency department settings can be sustained with below-average patient flows (fewer than 125 000 out-patient visits and fewer than 27 000 emergency department visits). pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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