Center to Improve System Performance of Substance Use Disorder Treatment

本核心卓越中心申请(P30)为续签布兰代斯/哈佛中心而改进 物质使用障碍治疗的系统绩效建议提高有效性和 现有研究对物质使用障碍(SUD)治疗服务交付和支付的影响，以及 为那些在此背景下研究和设计SUD治疗系统和政策的人提供国家资源 美国医疗保健系统正在发生的戏剧性变化。该中心的目标是进行和推广 关于服务交付和支付的研究，以协同扩大研究基础，告知政策和 将对SUD服务的成本、质量和可用性产生深远影响的实践决策。交织在一起的 交付和支付系统的性质需要兼顾两者，才能实现高可持续性 价值体系创新。在继续强调交付和支付系统创新的同时 广义地说，拟议的更新还将把有意的重点放在低障碍环境中进行治疗(即， 完全在专业SUD设置之外或扩展，例如急诊科、药房和 远程保健)，以及质量改进、服务提供和筹资方面的不平等，以及各种因素 影响创新的可持续性。续签还将扩大围绕医疗补助管理的科学 护理，鉴于医疗补助作为SUD服务的付款人的重要性，以及私人医疗补助的主导作用 健康计划。该中心将在三个组成部分研究项目的基础上，以及在 Brandeis、哈佛和其他地方，并支持新研究的发展，提供关键和及时的 能够为有效政策和实践的设计和实施提供信息的证据。行政部门， 研究、政策/传播和试点/指导核心提供组织引擎以促进 在不同项目之间相互促进研究成果，以支持中心的目标：1)通过 开展和促进有关支付和交付系统的研究和知识开发 SUD治疗的创新；2)通过指导和培训 种族/民族多元化的早期职业调查员人才库，并建立早期职业和高级职业网络 研究人员；以及，3)与关键利益攸关方进行双向交流，以产生及时和相关的成果 为政策和实践提供信息和影响的研究。该中心将通过延长 研究基础，包括对及时和新出现的主题进行的关键分析，并与 关键利益相关者。我们将通过包括经验性和概念性论文的活动来做到这一点；简短和 针对迫在眉睫的政策和实践问题的长期分析；以及多个指导计划和 支持早期职业调查人员的活动。此外，我们将把调查结果翻译和传播给 广泛的受众包括政策制定者、付款人、提供者、具有SUD实际经验的人，以及 研究人员告知不断变化的SUD治疗服务交付和支付环境。

This Core Center of Excellence application (P30) for the renewal of the Brandeis/Harvard Center to Improve System Performance of Substance Use Disorder Treatment proposes to enhance the effectiveness and impact of existing research on delivery and payment of substance use disorder (SUD) treatment services, and offer a national resource for those researching and designing SUD treatment systems and policy in the context of ongoing, dramatic changes in the US health care system. The Center’s goal is to conduct and extend research on service delivery and payment to synergistically expand the research base, informing policy and practice decisions that will profoundly affect the cost, quality, and availability of SUD services. The intertwined nature of delivery and payment systems requires attention to both in order to achieve sustainability of high value systems innovations. While continuing to emphasize innovations in delivery and payment systems broadly defined, the proposed renewal will also bring intentional focus to low-barrier settings for treatment (i.e., wholly outside of or extensions of specialty SUD settings such as emergency departments, pharmacies, and telehealth), as well as quality improvement, inequities in the provision and financing of services, and factors that influence sustainability of innovation. The renewal also will expand the science around Medicaid managed care, given the importance of Medicaid as a payer of SUD services, and the dominant role of private Medicaid health plans. The Center will build on three Component research projects, as well as related research at Brandeis, Harvard and elsewhere, and support the development of new research to provide crucial and timely evidence that can inform the design and implementation of effective policy and practice. The Administrative, Research, Policy/Dissemination, and Pilot/Mentoring Cores provide the organizational engine to promote cross-fertilization of findings across projects to support the Center’s aims: 1) advance the science by conducting and stimulating research and knowledge development about payment and delivery system innovation for SUD treatment; 2) drive the next generation of research by mentoring and training a racially/ethnically diverse pool of early career investigators and creating networks of early career and senior researchers; and, 3) engage with key stakeholders in a bidirectional exchange to produce timely and relevant research that informs and influences policy and practice. The Center will achieve these aims by extending the research base to include critical analyses of timely and emerging topics identified in close collaboration with key stakeholders. We will do this through activities that include empirical and conceptual papers; short- and longer-term analyses targeted at pressing issues for policy and practice; and multiple mentoring programs and activities to support early career investigators. Further, we will translate and disseminate findings to an expansive audience of policy makers, payers, providers, persons with lived experience of SUD, and researchers to inform the changing environment of delivery and payment of SUD treatment services.