Access and Retention in Treatment: Paying for preformance in Maine

Beginning in July 2007 the Maine Office of Substance Abuse instituted access and retention contract performance measures for all block grant contracted outpatient and intensive outpatient services. Contracted agencies receive quarterly payments based on meeting or exceeding measures on five measures: units of service, time from first call to first face to face, time to first treatment session, and two of three separate retention measures specific to the level of care (outpatient or intensive outpatient). Payments are based on data for these measures for the prior quarter and an agency can receive an incentive payment, and baseline payment, or a penalty payment of plus or minus 9% or the quarterly base payment. Preliminary results indicate that agencies participating in the Maine STAR SI grant learning collaborative and receiving coaching in process improvement methods are more likely to achieve or exceed the access and retention measures and receive baseline or incentive contract payments.

This presentation will review performance results of the first fiscal year of this new incentive based approach; as well as discuss how Maine has applied the NIATx process improvement model to increase access to treatment services and improve quality and performance at both the state and agency level. An overview of how the OSA as the Maine Single State Authority initiated application of the process improvement model to increase admissions to treatment will be provided; and the SSA's progress in supporting diffusion and spread of the model will be discussed.