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Monitoring Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

UPMC Health Plan Behavioral Health Services, together with UPMC for Life, monitors the rates at which members with alcohol or other drug dependence initiate and engage in treatment for these disorders. Participating in treatment is important to successful recovery.

To monitor these rates, UPMC Health Plan Behavioral Health Services uses a standardized national methodology contained in the Health Plan Employer Data and Information Set (HEDIS). Treatment initiation is defined as the percentage of adults diagnosed with alcohol or other drug dependence who begin treatment either through:

• An inpatient drug or alcohol admission.
• An outpatient service for drug and alcohol dependence and an additional drug and alcohol service within 14 days.

Treatment engagement is defined as the percentage of members who receive two additional drug or alcohol services within 30 days of initiating treatment. Rates for Initiation and Engagement of Alcohol and Other Drug Dependence Treatment for the UPMC for Life HMO (Medicare) population are as follows:

Barriers to members starting and engaging in substance abuse treatment may include:

• Member resistance to drug and alcohol treatment.
• Fear of the stigma of receiving drug and alcohol services.
• Lack of community supports.
• Lack of coordination of care between physical and behavioral health clinicians.
• UPMC for Life HMO (Medicare) members may be less likely to view substance use as an addiction and therefore be less likely to seek treatment.

UPMC Health Plan Behavioral Health Services and UPMC for Life have implemented the following interventions to improve the rates of initiation and engagement of alcohol and other drug dependence treatment:

• Adoption of the National Institute on Drug Abuse Principles of Drug Addiction Treatment: A Research-Based Guide treatment guideline, and distribution to the behavioral health provider network.
• Posting of educational resources regarding alcohol and drug treatment on our website.
• Distribution of a Behavioral Health Resource Guide to providers, which includes self-help and support groups available to members.
• Posting substance abuse treatment guidelines that include information about screening and interventions for Primary Care Physicians on the UPMC Health Plan website.

UPMC Health Plan Behavioral Health Services and UPMC for Life will continue to monitor initiation and engagement in drug and alcohol treatment and develop additional interventions, as needed, to improve these rates.

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