Incentives and Alerts for Improving Performance in Washington State

描述（由申请人提供）：改善华盛顿州绩效的激励措施和警报有关治疗过程措施（例如，护理措施的启动、参与和连续性）的信息可用于专业药物滥用治疗计划，以跟踪其绩效并确定质量改进工作的目标领域。华盛顿州行为健康和恢复司（DBHR）将合作研究两种干预措施的影响，财政激励和客户特定的警报系统，对计划的性能和客户的结果。特定于客户的警报将增强该州已经到位的数据系统。警报将重点关注门诊、强化门诊、戒毒和住院项目，每周为项目提供有关可能未达到建议服务水平的特定客户的信息，以便项目能够跟进这些客户，目标是改善他们的绩效指标。拟定设计将华盛顿州的项目随机分为以下研究组：A组（对照组）、B组（仅激励组）、C组（仅警报组）、D组（激励和警报组）。这两种干预措施对可能经历健康差异的亚群（例如，种族/族裔少数群体或农村人口）。最后，将探讨客户和治疗方案的特点对激励措施和警报系统的影响。具体目标如下：1.检查是否仅提供奖励或提供 特定于客户的警报只会导致改进的方案绩效和客户成果。 2.检查特定于客户的警报与激励措施相结合是否会在仅激励措施或仅警报的基础上进一步改善计划绩效和客户成果。 3.探索仅激励措施、仅警报措施或激励措施加警报措施是否对子人群的计划绩效有不同的影响（例如，种族/少数民族和农村客户）。 4.评估客户和项目群层面的因素是否与项目群实现和保持良好绩效的能力相关。

DESCRIPTION (provided by applicant): Incentives and Alerts for Improving Performance in Washington State Information on treatment process measures (e.g. initiation, engagement, and continuity of care measures) can be useful to specialty substance abuse treatment programs for tracking their performance and targeting areas for quality improvement efforts. The Washington State Division of Behavioral Health and Recovery (DBHR) will collaborate to study the impacts of two interventions, financial incentives and a client-specific alert system, on program performance and client outcomes. Client-specific alerts will be an enhancement to the data systems that are already in place in the state. Focusing on outpatient, intensive outpatient, detoxification, and residential programs, the alerts will provide programs with information, on a weekly basis, regarding specific clients who may not be meeting recommended levels of services so programs will be able to follow up with these clients with the goal of improving their performance measures. The proposed design will randomize programs in Washington State into the following study groups: Group A (Control Group), Group B (Incentives Only Group), Group C (Alerts Only Group) Group D (Incentives and Alerts Group). The differential impacts of these two interventions on the quality of care for subpopulations that may experience health disparities (e.g., racial/ethnic minorities or rural populations) will also be examined. Finally, the influenceof client and treatment program characteristics on the impacts of incentives and alert systems will be explored. The specific aims are as follows: 1. Examine if offering incentives only or providing client-specific alerts only leads to improved program performance and client outcomes. 2. Examine if client-specific alerts in combination with incentives lead to additional improvement in program performance and client outcomes beyond that of incentives only or alerts only. 3. Explore if there are differential impacts of incentives only, alerts only, or incentives plus alert on program performance by subpopulations (e.g., racial/ethnic minorities and rural clients). 4. Evaluate if client and program level factors are associated with programs' ability to achieve and maintain good performance.