Less than 1 percent of health plan members are actually diagnosed with alcoholism or related disorders, according to data from a national performance measurement project released today in New York City at the American Medical Association Media Briefing, Alcohol Dependence: From Science to Solutions.
Based on general population rates, health plans should be diagnosing at least four or five times as many members with alcohol problems.
"This project offers concrete evidence of the scale of the challenge to improve the identification and treatment of alcohol dependence among America's workers," said Eric Goplerud, Ph.D., director of Ensuring Solutions to Alcohol Problems at the George Washington University Medical Center in Washington, D.C. Researchers at Ensuring Solutions analyzed data from the alcohol use disorders section of the 2005 eValue8 RFI Initiative, which captures voluntarily reported data from more than 250 health plans nationwide. The National Business Coalition on Health, a national membership organization of regional employer coalitions that aims to improve health care quality, sponsored the project.
The findings indicate that the systemic failure to address alcohol dependence begins with a failure to adequately identify people with alcohol problems. Although approximately 8 percent of working adults suffer from alcohol dependence or a related condition, only about .06 percent of all health plan members (or just 8 percent of those estimated to have the disease) receive such a diagnosis. In comparison, health plans identify about 40 percent of patients with depression, 65 percent of diabetics and 70 percent of those with hypertension.
The data also showed that less than half--44 percent--of members identified as alcohol dependent attend even a single alcohol or drug treatment session within 14 days. Only about 16 percent receive the recommended three chemical dependency health care services in the month following diagnosis. Health plans also are failing to reach out to members in ways that would promote successful treatment, Dr. Goplerud said. For example, few plans are sending educational materials, and only 17 percent are making follow-up calls to members who miss appointments.
However, the responsibility lies not just with health plans but with physicians, employers and others who have not treated alcohol dependence on par with other diseases, said Dr. Goplerud, who is also a research professor in the Department of Health Policy at the GWU School of Public Health and Health Services.