Are You Ready to Meet the Criteria for Pay-for-Performance?

Are You Ready to Meet the Criteria for Pay-for-Performance?

Everyone knows the business of Addiction Treatment needs to change for the good of the clients, the community at large and the nation. The latest trend for insurers is the pay-for-performance model. Are you ready to meet this challenge?

We know that:

  • Recidivism rates are too high
  • Treatment facilities need to have quality trained and licensed staff
  • Implementation of Best Practices is uniformly needed
  • Aftercare programs must be designed using best practices
  • Clients need access to aftercare for an extended period
  • Collection, analysis, and changes based upon real time data can improve outcomes

Licensed sober living homes utilizing best practices in aftercare are needed to stabilize early recovery. The last few decades have demonstrated that the acute care model is not applicable in treating addiction.

In a 2011 study, published by the Journal of Substance Abuse Treatment (Sept:41 (2):193-200) the researchers found that the pay-for-performance including bonuses altered counselor behavior, and increased client retention. Indeed the retention ratio went from 40% to 53% in a 90-day period.

The issues raised in pay-for-performance are indeed complex. A special meeting of the Washington Circle, (supported by NIDA and comprised of a multidisciplinary group of experts convened to examine research gaps in performance measures for substance use disorders. Reforms in health care have heightened the need for accountability in performance measures regarding patients suffering from mental health and substance use disorders.

While many best practices already exist that address biology, behavior and social issues related to substance use disorders, many facilities do not incorporate these effective treatment protocols. Members of the review panel questioned organizational readiness, resources and leadership as obstacles to implementing these changes successfully.

Areas of concern here:

  • Inclusion of medication to treat addictive disorders on a health plan’s formulary
  • Rate of collecting and reporting data on clients’ perception of care using standardized instruments
  • Measure of management practices
  • Measures of connections between organizational providers across the continuum of treatment services (primary treatment providers to sober living communities)
  • Development of Outcome Measures that go beyond the medical sector and include recovery support, family, housing/homeless, child welfare, education, work, criminal justice.

It is important for organizations to consider structural measures that evaluate leadership/management, clinical and administrative functions, philosophies, workforce issues, staff productivity and performance and organizational culture to name a few. While that may seem overwhelming, the technology exists to help find the issues and the answers today.

Recovery Passport Solutions Helps Implement Needed Changes 

The use of electronic programs can enlighten the way Providers conceive treatment programs and measure outcomes of clients and staff in real data. More states and insurance companies will be looking to pay-for-performance as a means a determining payment.

Recovery Passport Solutions encompasses all the above-mentioned issues. Our tools, available to clients 24/7, 365 days a year make it easy for clients to maintain a continuum of care long after they have left the treatment program. Clinician/client relationships continue providing Providers answers to stabilizing early recovery and performing early interventions. Furthermore, if pay-for-performance becomes the standard then Providers will have the data to respond immediately.

Improving the quality of care while expanding accessibility can only help improve treatment outcomes. Recovery Passport Solutions helps you manage the fast changing world of health care.


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