186279 Access and Retention in Treatment: Paying for preformance in Maine

Tuesday, October 28, 2008

Linda Joy Frazier, MA, RN, CHES , Dhhs, Maine Office of Substance Abuse, Augusta, ME
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.

Learning Objectives:
1) Introduce the four key preformance measures used to improve access and retention in treatment. 2)Present how the SSA in Maine incorporated these key measures into incentive based treatment contracts for outpatient addiction treatment; 3)Discuss the importance of linking preformance measures to contract payment in improving access and retention in addiction treatment across the state system of care.

Keywords: Access and Services, Treatment System

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an RN and CHES that has worked in women's health, college health, and addiction services since 1983. I have been the criminal justice and treatment manager of the Maine Office of Substance Abuse (OSA), the Single State Authority (SSA) since 2002 and in that capacity oversee all addiction treatment contracts for the state of Maine. OSA currently has both a RWJ Advancing Recovery Grant and the State Access and Retention Systems Grant. I am the state change leader for both of these two grants am also certified by NIATx as a process improvement change leader.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.