Improving quality and equity of opioid use disorder treatment using a multi-state Medicaid research network

利用多州医疗补助研究网络提高阿片类药物使用障碍治疗的质量和公平性

• 批准号: 10771064
• 负责人: Andrew James Barnes
• 金额: $ 255.4万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10771064
• 关键词: Accounting; Caring; Case Mixes; Continuity of Patient Care; Data; Decision Making; Disparity; Effectiveness; Enrollment; Equity; Ethnic Origin; Federally Qualified Health Center; Feedback; Freedom; Goals; Grant; Healthcare; Housing; Improve Access; Individual; Inequity; Infrastructure; Intervention; Learning; Managed Care; Measurement; Measures; Medicaid; Methods; Minority Groups; Modality; Modeling; National Institute of Drug Abuse; Outcome; Outpatients; Overdose; Patient Outcomes Assessments; Patients; Pharmaceutical Preparations; Physicians; Policies; Policy Analysis; Policy Maker; Population; Process Measure; Provider; Quality of life; Quasi-experiment; Race; Reporting; Research; Research Project Grants; Risk Factors; Sampling; Security; Subgroup; Surveys; System; Testing; Universities; Variant; barrier to care; behavioral health; beneficiary; comparison group; effectiveness evaluation; experience; follow-up; health equity; improved; intervention effect; medication for opioid use disorder; novel; opioid treatment program; opioid use; opioid use disorder; patient engagement; perceived discrimination; programs; provider factors; psychosocial; residential segregation; response; social deprivation; socioeconomics; substance use treatment; treatment effect

Project Summary Medicaid covers the majority of individuals who need opioid use disorder (OUD) treatment and disproportionately covers minoritized populations and those with socioeconomic risk factors. Improving OUD treatment quality in Medicaid thus can reach large numbers and inform efforts to redress inequities in care. State Medicaid programs have changed policy to expand the continuum of care, remove barriers to treatment, and improve the quality of OUD care. However, states have taken these actions amidst OUD quality measurement systems that are underdeveloped limiting opportunities for targeted intervention and robust evaluation of policy effects. Current OUD quality measures are limited in three key ways. First, OUD quality measures are seldom constructed at the provider-level, despite the fact that clinicians, practices, and facilities are the most likely locus of intervention for quality improvement programs. Second, few measures incorporate OUD patient-reported outcomes or experiences of care. Third, quality measures are typically not reported by population sub-group and thus fail to identify inequities in treatment based on race and ethnicity amenable to policy and programmatic changes. The Medicaid Outcomes Distributed Research Network (MODRN) has supported Medicaid agency efforts to improve OUD treatment by developing novel measures of treatment quality and examining effects of treatment quality on overdose. MODRN will develop Equity and QUality Improvement for Medicaid Programs (EQUIP) and draw on our robust university-state partnerships in 12 states accounting for 24% of the US Medicaid population. Our overarching goal is to develop OUD quality measures that can be constructed at the provider-level, incorporate patient experience, and center health equity. Efficient and sustainable OUD quality measures developed and implemented by MODRN-EQUIP will guide quality improvement initiatives and Medicaid policy decisions. Our goal will be achieved through three integrated research projects aiming to: 1) develop provider-level OUD quality measures using Medicaid administrative data; 2) measure OUD patient- reported outcomes and examine associations with claims-based quality measures to guide quality and equity improvement, and 3) implement and examine the effectiveness of a practice-level quality improvement intervention for OUD. A State Steering Committee of Medicaid leaders will oversee MODRN-EQUIP, drawing on infrastructure supported by prior NIDA grants (R01DA055585 and R01DA048029). These research projects will be executed by a Coordinating Center, a Methods Core and an Engagement and Dissemination Core that draws on the expertise of Medicaid beneficiaries, providers, managed care organizations and policymakers to develop quality measurement and management systems to transform substance use treatment. We will disseminate our findings through state policy networks to reach beyond our 12 states to other Medicaid programs.

项目摘要 医疗补助涵盖了需要阿片类药物障碍（OUD）治疗的大多数人 不成比例地涵盖少数人口和具有社会经济风险因素的人群。改进 因此，医疗补助的治疗质量可以达到大量，并为纠正护理不平等的努力提供努力。 州医疗补助计划已改变政策，以扩大护理的连续性，消除治疗障碍， 并提高OUD护理的质量。但是，各州在质量中采取了这些行动 测量系统是针对性干预和鲁棒的限制机会欠发达的系统 评估政策效果。当前的OUD质量措施以三种关键方式受到限制。首先，Oud质量 尽管临床医生，实践和设施 是质量改进计划的最有可能的干预措施。其次，很少有措施合并 OUD患者报告的结果或护理经验。第三，质量措施通常不会由 人口子组，因此无法根据种族和种族识别治疗中的不平等现象 政策和程序化更改。 医疗补助结果分布式研究网络（MODRN）支持医疗补助机构的努力 通过制定新的治疗质量测量和检查治疗的影响来改善OUD治疗 过量服用的质量。 MODRN将为医疗补助计划建立公平和质量改进 （设备）并利用我们在12个州的强大大学国家合作伙伴关系，占美国24％ 医疗补助人口。我们的总体目标是制定可以在 提供者级别，结合患者经验和中心健康公平。高效且可持续的Oud质量 Modrn-Equip制定和实施的措施将指导质量改进计划，并 医疗补助政策决定。我们的目标将通过三个综合研究项目实现：1） 使用医疗补助行政数据制定提供商级别的OUD质量措施； 2）测量OUD患者 - 报告结果并检查与基于索赔的质量措施的关联，以指导质量和公平 改进，以及3）实施和研究实践级质量改进的有效性 干预。 医疗补助领导人的州指导委员会将监督Modrn-Equip，利用基础设施 由先前的NIDA赠款（R01DA055585和R01DA048029）支持。这些研究项目将被执行 通过协调中心，方法核心以及参与和传播核心 医疗补助受益人，提供者，托管护理组织和政策制定者的专业知识来发展 质量测量和管理系统，以改变药物使用处理。我们将传播 我们通过国家政策网络的发现超出了12个州的其他医疗补助计划。