Substance Use Illness: Patient-Focused Episodes of Care 

Documentation:

Workshop Summary, A Path Forward to Measuring Continuing Care Management for Substance Use Illness: Patient-Focused Episodes of Care (PDF)

White Paper, A Path Forward to Measuring Continuing Care Management for Substance Use Disorders: Patient-Focused Episodes of Care (PDF)

Opportunity

This project will build upon prior work at the NQF completed under the National Voluntary Consensus Standards for the Treatment of Substance Use Conditions: Evidence-Based Treatment Practices project, as well as ongoing work under the auspices of the priority setting pilot project which has developed and endorsed a measurement framework for evaluating efficiency—defined as quality and costs—across patient-focused episodes of care. The aim of this project is to lay out a path forward for substance use illness quality measurement specific to continuing care management.

The goal of this project is to produce an action plan to operationalize measurement of the NQF-endorsed practice of continuing care management of substance use illness, by applying NQF’s measurement framework for evaluating efficiency across patient-focused episodes of care.

About the Project

Over the past 15 years, it has become clear that substance use conditions are in many ways like other chronic health conditions requiring long-term management. In 2006, NQF endorsed a set of evidence-based practices for the treatment of substance use conditions. One of those practices was focused continuing care management of substance use illness, specifically: Patients with substance use illness should be offered long-term, coordinated management of their care for substance use illness and any coexisting conditions, and this care management should be adapted based on ongoing monitoring of their progress.

However, without a measurement strategy, it is not possible to identify performance and improve treatment. Given the longitudinal and chronic nature of substance use illness and its attendant coordination needs, as well as the vital role of patient empowerment and knowledge, substance use illness is an excellent example of the utility of an episode-based model to assess what constitutes optimal care and how this can be achieved in the most efficient manner. Under the guidance of a planning committee of leading experts in the field, the NQF will convene a workshop to explore adapting this model to substance use illness treatment.

Scope

Specifically for this project, the NQF will work with the full range of stakeholders to:

Commission a white paper that will analyze the current state of the field of continuing care management of substance use illness and the key issues around the development of a measurement strategy utilizing a value-based episode of care approach. The white paper for this project will aim to:

• Outline the concept of patient-focused episodes of care, emphasizing the direct connection to substance use illness treatment, particularly continuing care management;
• Identify existing measures or those under development and perceived gaps;
• Identify the parameters and key elements for continuing care management;
• Highlight the key issues around measuring continuing care management in substance use illness; and
• Map the path forward for quality measurement of continuing care management.

Plan and convene a workshop to create an action plan for developing measures of the NQF-endorsed practice of continuing care management of substance use illness. The workshop discussion will build on the commissioned white paper. It was designed to result in a recommended action plan for developing measures of the NQF-endorsed practice of continuing care management of substance use illness. The action plan will address:

• The framework for measurement specific to substance use illness;
• The type and focus of measures needed;
• Identification of existing measures and priorities for development;
• Parameters and key elements for continuing care management that should be captured in measures; and
• Specific considerations regarding NQF measure criteria for development of the substance use measures.

Access the presentations.

Process

This project, like all NQF activities, involves the active participation of representatives from across the spectrum of healthcare stakeholders. The project is guided by a Planning Committee.

Funding

Primary support for this project is provided by the Open Society Institute (OSI) and the Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA).

Related Work

• Substance Use Conditions: Evidence-Based Treatment Practices (PDF)
  
• Episodes of Care Framework Measurement

Contact Information

For more information, contact Anisha S. Dharshi, Program Director, at 202-783-1300 or info@qualityforum.org.