Sustaining SBIRT in the wild: simulating revenues and costs for Screening, Brief Intervention and Referral to Treatment programs

• DOI: 10.1111/add.13650
• Publication Date: 2017-01-13T10:06:31Z
• Authors: Alexander J. Cowell; William N. Dowd; Michael J. Mills; Jesse M. Hinde; Jeremy W. Bray
• Keywords: Brief intervention; Staffing; Reimbursement

To examine the conditions under which Screening, Brief Intervention and Referral to Treatment (SBIRT) programs can be sustained by health insurance payments.A mathematical model was used estimate number of patients needed for revenues exceed costs.Three medical settings in United States were examined: in-patient, out-patient emergency department. Components SBIRT delivered combinations health-care practitioners (generalists) behavioral specialists.Practitioners seven who received grants from US Substance Abuse Mental Health Services Administration (SAMHSA).Program costs measured using data grantees. Patient flows administrative adjusted with prevalence screening estimates literature.SBIRT through reimbursement department most staffing mixes. sustain in-patient programs, a patient flow larger than national average may needed; if that is achieved, range screens required maintain surplus narrow. Sensitivity analyses suggest results are very sensitive changes proportion insured patients.Screening, payments variety models. only an setting above-average (more 2500 screens). below-average (fewer 125 000 visits fewer 27 visits).