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federal efforts to improve the quality of care through the electronic health records (ehr) incentive programs also may be used to improve substance use disorders care. for example, the ehr incentive programs have created incentives for providers to measure and report patient-level substance use disorder quality of care indicators, including patients’ (1) use of medication-assisted treatment (mat) to manage opioid use disorder, (2) treatment of mental health conditions (e.g., anxiety, depression, and insomnia), and (3) substance use disorder diagnosis, treatment, and follow-up. ²⁷⁰ these program data can help assess the quality of care for patients with substance use disorders.

further, the value-based purchasing program provides incentives for providers to meet quality benchmarks, including the number of patients receiving a substance use disorder diagnosis, receiving a medication-assisted treatment, and receiving a mental health diagnosis and treatment. the federal government can also use value-based purchasing to encourage providers to be more selective about the medications they prescribe, including for opioid use disorder, by paying them for fewer, more effective drugs.

studies of primary care sbi have focused on screening and brief intervention for alcohol misuse. ^{45, 46} the uspstf recommends screening for alcohol misuse for all adults ages 18 to 75 years who have or are at high risk for chronic heavy drinking, and for all adults ages 21 to 65 years who are at risk for hazardous drinking or at high risk for alcohol-related problems. ⁴⁵ the uspstf also recommends screening for alcohol misuse in all pregnant women. screening should be conducted by health care professionals who can provide brief counseling based on the patient’s risk status. ⁴⁶

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