Child development or adult addictions: Are your patients getting screened?

More than a year has passed since the first coordinated care organizations were established in Oregon, and our work is well underway. One major area of focus under the CCO model is early screening and prevention strategies.

Providence Health & Services is a partner in Health Share of Oregon, the largest of the state’s CCOs, which aims to transform medical, behavioral and ultimately dental care for Oregon Health Plan members in Multnomah, Clackamas and Washington counties.

The primary focus of CCOs is to prevent illness, increase access to care, improve the quality of health care, eliminate disparities and curb rising health care costs. The Oregon Health Authority measures an organization’s performance by several quality and outcomes metrics, including how well it meets benchmarks on:

  • Prevention: Such as adolescent well-care visits and colorectal cancer screening
  • Access: Such as emergency department and ambulatory care use
  • Chronic-condition management: Such as controlling high blood pressure and glucose levels in patients with diabetes

Providence also is paying close attention to two other performance measures:

  • Alcohol and drug misuse screening
  • Child developmental screening

Providence Health Plan members 18 or older should be screened for alcohol and drug misuse. If substance abuse is suspected, a brief intervention is recommended, followed by referral to treatment. This evidence-based approach, called SBIRT, is designed to address substance abuse before it escalates. The Oregon Health Authority has developed specifications for SBIRT coding.

Oregon Health & Science University’s Family Medicine Department is leading a residency curriculum project to teach the SBIRT method to primary care clinicians. The program is expected to train nearly 400 internal, preventive and family medicine residents throughout the state. These specially trained physicians are likely to practice in team-based, patient-centered medical homes after graduation, and they ultimately will make a more meaningful difference in the health of our communities.

At Providence Medical Group-Milwaukie and Providence Medical Group-Southeast, SBIRT has been built into the Epic health records system.

In a second key performance measure, children should undergo a developmental screening (CPT code 96110) by age 36 months. The tool measures a child’s social and emotional development and identifies delays or potential disabilities.

The most common standardized screening tool is the Ages and Stages Questionnaire, or ASQ, which can be purchased online. Providers can administer the questionnaire during a well-child visit. If you have concerns with any of the results, please refer the child for an early intervention or to a child development specialist.

For continuity of care, the specialist can keep you informed of the child’s progress and outcomes. Keep in mind that signed HIPAA and Family Educational Rights and Privacy Act (FERPA) release forms are required to allow you and the early intervention specialist to share patient information. Download the FERPA form.

Health Share is one of 16 Oregon CCOs established under the Affordable Care Act. Besides Providence, members include Adventist Health, CareOregon, Central City Concern, Kaiser Permanente, Legacy Health, Oregon Health & Science University, Tuality Healthcare and behavioral health from Clackamas, Multnomah and Washington counties. To learn more, visit Health Share’s website or follow on Twitter @HealthShareOR.