RESEARCH TRIANGLE PARK, N.C. — Researchers at RTI International (RTI), a nonprofit research institute, have developed two quality measures aimed at helping providers, payers and health systems work together to improve the quality of addiction treatment.
“Opioid overdose deaths reached their highest levels in 2020,” said Dr. Tami Mark, senior director of behavioral health financing and quality measurement at RTI. “Substance use disorders can be effectively treated with medications and therapies, but many addiction programs fail to both offer effective treatments, and to help patients stay in treatment long enough to benefit. These two measures should help providers improve their processes and result in better patient outcomes.”
The two measures are:
- Prescription or administration of pharmacotherapy to treat opioid use disorder (OUD), which measures the percentage of a provider’s patients with an OUD diagnosis who filled a prescription for, or were administered, an FDA-approved medication to treat OUD.
This measure can help systems uncover the root causes of patients not receiving effective opioid use disorder medications and fix those problems. Medications to treat OUD can reduce death from OUD in half, yet only 40 percent of specialty addiction treatment facilities offer these medications.Access to prescribing physicians, lack of insurance coverage, and lack of training are among the many barriers preventing greater use.
- Continuity of care after receiving hospital or residential substance use disorder (SUD) treatment, which measures the percentage of patients treated for a substance use disorder at an inpatient or residential provider that received follow-up treatment within seven or 30 days after discharge.
This measure can help systems learn which providers are able to connect patients to follow-up treatment and how they are able to do so. These lessons can then be disseminated to all providers to improve follow-up rates. Remaining in addiction treatment for an adequate period is critical for recovery. Studies find that, on average, only 25 percent of Medicaid beneficiaries receive a post-discharge follow-up within 14 days of a residential or inpatient SUD stays. Patients who drop out of SUD treatment during transitions from inpatient to outpatient settings are at higher risk for continued substance use and overdose deaths.
The two quality measures are created using insurance claims data and therefore place minimal data collection burden on providers. Unlike most existing substance use disorder quality measures, they were developed and tested as provider-level measures. RTI’s extensive testing demonstrated that the measures meet the criteria of being high impact, valid, reliable, feasible and useful.