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ObjectivesIn 2013, the American Society of Addiction Medicine (ASAM) approved its Standards of Care for the Addiction Specialist Physician. Subsequently, an ASAM Performance Measures Panel identified and prioritized the standards to be operationalized into performance measures. The goal of this study is to describe the process of operationalizing 3 of these standards into quality measures, and to present the initial measure specifications and results of pilot testing these measures in a large health care system. By presenting the process rather than just the end results, we hope to shed light on the measure development process to educate, and also to stimulate debate about the decisions that were made.MethodsEach measure was decomposed into major concepts. Then each concept was operationalized using commonly available administrative data sources. Alternative specifications examined and sensitivity analyses were conducted to inform decisions that balanced accuracy, clinical nuance, and simplicity. Using data from the US Veterans Health Administration (VHA), overall performance and variation in performance across 119 VHA facilities were calculated.ResultsThree measures were operationalized and pilot tested: pharmacotherapy for alcohol use disorder, pharmacotherapy for opioid use disorder, and timely follow-up after medically managed withdrawal (aka detoxification). Each measure was calculable with available data, and showed ample room for improvement (no ceiling effects) and wide facility-level variability.ConclusionsNext steps include conducting feasibility and pilot testing in other health care systems and other contexts such as standalone addiction treatment programs, and also to study the specification and predictive validity of these measures.

Abstract The Patient Protection and Affordable Care Act (PPACA) aims to provide affordable health insurance and expanded health care coverage for some 32 million Americans. The PPACA makes provisions for using technology, evidence-based treatments, and integrated, patient-centered care to modernize the delivery of health care services. These changes are designed to ensure effectiveness, efficiency, and cost-savings within the health care system. To gauge the addiction treatment field’s readiness for health reform, the authors developed a Health Reform Readiness Index (HRRI) survey for addiction treatment agencies. Addiction treatment administrators and providers from around the United States completed the survey located on the http://www.niatx.net website. Respondents self-assessed their agencies based on 13 conditions pertinent to health reform readiness, and received a confidential score and instant feedback. On a scale of “Needs to Begin,” “Early Stages,” “On the Way,” and “Advanced,” the mean scores for respondents (n = 276) ranked in the Early Stages of health reform preparation for 11 of 13 conditions. Of greater concern was that organizations with budgets of $5 million to have information technology (patient records, patient health technology, and administrative information technology), evidence-based treatments, quality management systems, a continuum of care, or a board of directors informed about PPACA. The findings of the HRRI indicate that the addiction field, and in particular smaller organizations, have much to do to prepare for a future environment that has greater expectations for information technology use, a credentialed workforce, accountability for patient care, and an integrated continuum of care.

The country's system of providing treatment for people struggling with addiction requires a fundamental overhaul. To address these daunting problems, a group of experts from outside the addiction field met in an intensive retreat and envisioned a new future for addiction treatment that would use the latest available technology. Retreat leaders employed creative techniques to help free up thinking beyond incremental improvement ideas. Current and former addicts or alcoholics and family members also attended the retreat to provide the panelists with a realworld understanding of their lives. Through this process, the panelists generated eight idea categories that visualized future treatments for addiction using technology. They were: (1) Integrated System and Record; (2) Monitoring/Treatment; (3) Virtual Experiences; (4) Treatment Access and “One Stop Shop”; (5) Networks; (6) Tailored Media Campaigns; (7) Diagnostic Tools; and (8) Help for Family. Two stories illustrate how these ideas could help a heroin addict and an alcoholic. The sponsors plan another meeting to bring these visionary concepts closer to real application. [ABSTRACT FROM AUTHOR]

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No abstract available for this article. [ABSTRACT FROM PUBLISHER]