RM1DA059377

Person-Centered Quality Measurement and Management in a System for Addictions Treatment in New York State - Project Summary

In 2021, the number of drug overdoses in New York continued to rise, with 4,946 deaths involving opioids. Synthetic opioids are driving the rise as these are mixed with other substances taken by people who use drugs (PWUD). Alarmingly, the rates of overdose deaths are rising faster for Black and Latinx individuals, exacerbating health inequities.

The New York State agency that regulates addictions treatment—the Office of Addiction Services and Supports (OASAS)—oversees a system that annually serves 350,000 individuals with substance use disorders (SUD). Within the system, outpatient clinics provide the majority of treatment services for individuals with opioid use disorders (OUD).

In response to the continuing opioid crisis, OASAS is calling for new approaches that embrace person-centered care, evidence-based practices, equitable treatment, and harm reduction principles. OASAS envisions a revised treatment system that better retains clients in treatment, mitigates adverse healthcare events, and reduces deaths.

To drive change, OASAS will invest in a quality measurement and management (QM2) strategy that provides performance feedback to activate leadership and staff of clinics to improve practice as well as publicizes quality measures to ensure public accountability. Using the Donabedian framework as a guide, the OASAS QM2 strategy will include a suite of structural (e.g., client/counselor ratios), process (e.g., use of medications for OUD), and outcome (e.g., hospitalization for detoxification) quality measures.

In support of the strategy, OASAS will also provide funding to ensure all clinics have electronic health records (EHR) that have capacity to capture and report on quality measures. The OASAS strategy will address common barriers to QM2 efforts, including: inadequate technological capacity at clinics, dearth of validated quality measures for SUD treatment, limited data literacy in the workforce, insufficient expertise in change management among staff, and clinic leadership resistance due to concerns about fairness in accounting for the clinical complexity of their clients.

In addition, OASAS recognizes that gathering data directly from patients is essential to assessing whether their goals and needs are addressed in a person-centered system of care. OASAS will work with academic partners to develop measures and provide support to clinics to address these barriers.

This QM2 Research Center (QM2-RC) proposal comes from an academic-government partnership that has a longstanding history of collaborating on studies to improve treatment for SUD. The broad aim is to build then test a science-based QM2 strategy for person-centered treatment. The project will leverage OASAS's investment in its new QM2 strategy and policy leadership. The academic partners will offer expertise in statistical methods for measurement validation, risk adjustment, and causal inference that will address some obstacles to QM2 as well as build the evidence base for the benefits of the strategy. The team will also assess how clinics and other stakeholders—e.g., patients, payers—incorporate the QM2 strategy into practice improvement, contract negotiations, and choosing clinics.

New York University

TO SUPPORT BASIC AND CLINICAL NEUROSCIENCE, BIOMEDICAL, BEHAVIORAL AND SOCIAL SCIENCE, EPIDEMIOLOGIC, HEALTH SERVICES AND HEALTH DISPARITY RESEARCH. TO DEVELOP NEW KNOWLEDGE AND APPROACHES RELATED TO THE PREVENTION, DIAGNOSIS, TREATMENT, ETIOLOGY, AND CONSEQUENCES OF DRUG ABUSE AND ADDICTION, INCLUDING HIV/AIDS. TO SUPPORT RESEARCH TRAINING AND RESEARCH SCIENTIST DEVELOPMENT. TO SUPPORT DISSEMINATION OF RESEARCH FINDINGS. SMALL BUSINESS INNOVATION RESEARCH (SBIR) LEGISLATION IS INTENDED TO EXPAND AND IMPROVE THE SBIR PROGRAMS TO EMPHASIZE AND INCREASE PRIVATE SECTOR COMMERCIALIZATION OF TECHNOLOGY DEVELOPED THROUGH FEDERAL SBIR RESEARCH AND DEVELOPMENT, INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN THE SBIR PROGRAM. THE LEGISLATION INTENDS THAT THE SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.279 - Drug Abuse and Addiction Research Programs

National Institute on Drug Abuse (NIDA) [HHS - NIH]

New York, New York 100165267 United States

Single Zip Code

HEAL Initiative: Research to Foster an Opioid Use Disorder Treatment System Patients Can Count On (RM1 - Clinical Trial Optional) (RFA-DA-23-046)

Amendment Since initial award the total obligations have increased 93% from $2,418,887 to $4,675,685.