HEDIS Measure: Unhealthy Alcohol Use Screening and Follow-Up

Why focus on unhealthy alcohol use? 

Unhealthy alcohol use is a common and serious issue, ranging from risky drinking to alcohol dependence1. About 30% of the U.S. population misuses alcohol, and 21% of adults report engaging in risky or hazardous drinking2. Alcohol misuse accounts for 1 out of 10 deaths in the United States3

Even though this issue is widespread, there is a lack of screening and follow up with intervention services. The U.S. Preventive Services Task Force recommends that clinicians “screen adults aged 18 and older for alcohol misuse and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse.” Work done by NCQA has shown low screening and follow-up rates—there is room for improvement. 

What is the Unhealthy Alcohol Use Screening and Follow Up measure? 

With funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) and FEi Systems, NCQA developed the Unhealthy Alcohol Use Screening and Follow-Up measure, the first to evaluate health plan performance on unhealthy alcohol use screening and follow-up care for the general adult population. In June 2017, the measure was added to HEDIS4 for health plan reporting. 

Unhealthy Alcohol Use Screening and Follow-Up
The percentage of members 18 years or older who were screened for unhealthy alcohol use using a standardized tool and, if screened positive, received appropriate care. 

Two rates are reported: 

  1. Screening: The percentage of members who were screened using a standardized tool for unhealthy alcohol use. 
    1. Denominator: Adults 18 or older 
    2. Numerator: Those who were screened for unhealthy alcohol use 
  2. Counseling or Other Follow-Up: The percentage of members who received brief counseling or other follow-up care within 2 months of a positive screening. 
    1. Denominator: Adults 18 or older who scored positive for unhealthy alcohol use 
    2. Numerator: Those who received follow-up care 

The measure is reported with the use of electronic clinical data sources (ECDS), which includes EHRs, registry and case management. 

What now? 

With renewed funding from SAMHSA, the Centers for Disease Control and Prevention (CDC) and FEi Systems, NCQA is working to improve the quality of care and health plan reporting of the Unhealthy Alcohol Use Screening and Follow Up measure through a Learning Collaborative. This quality improvement learning collaborative will span two years (2017–2019) and will include activities and resources such as: 

  • A practice change package that includes activities and resources to enhance quality of care and reporting. 
  • Regular meetings (including check-ins, webinars and two in-person meetings) to share experiences and ideas with experts and other participating health plans. 

If your plan is interested in participating in the Learning Collaborative, please contact alcohollearningcollaborative@ncqa.org.


1 Jonas, Daniel E. et al., 2012. “Behavioral Counseling After Screening for Alcohol Misuse in Primary Care: A Systematic Review and Meta-analysis for the U.S. Preventive Services Task Force.” Annals of Internal Medicine 157:645–54.

2 Vinson, D.C., B.K. Manning, J.M. Galliher, L.M. Dickinson, W.D. Pace, B.J. Turner. 2010. “Alcohol and sleep problems in primary care patients: a report from the AAFP National Research Network.” Ann Fam Med 8(6):484-92

3 Stahre M, Roeber J, Kanny D, Brewer RD, Zhang X. Contribution of Excessive Alcohol Consumption to Deaths and Years of Potential Life Lost in the United States. Prev Chronic Dis 2014;11:130293. DOI: http://dx.doi.org/10.5888/pcd11.130293

4 HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).