Development, Testing, and Dissemination of a Public-Facing Tool to Help Consumers Find Higher-Quality Addiction Treatment.

OBJECTIVE: The authors aimed to describe the development and testing of quality measures included in a public-facing addiction treatment facility search engine. METHODS: An addiction treatment facility survey was created that queried providers in six U.S. states about whether they offered the services and used the processes identified by federal agencies and nonprofit organizations as signs of higher-quality addiction treatment. Four insurance claims-based quality measures were created to capture the percentage of a provider's patients with opioid use disorder receiving opioid use disorder medications, who filled prescriptions for such medication for at least 180 days, who received follow-up care after treatment for substance use disorder in inpatient or residential settings, or who had a substance use disorder-related hospitalization or emergency department visit. A patient experience-of-care survey captured patients' perceptions of the quality of the addiction treatment. The project was undertaken from November 2018 through July 2020. RESULTS: The authors tested the measures by using 1,245 facility surveys, 7,970 patients' experience-of-care surveys, and four claims-based measures submitted by 129, 136, 283, and 408 addiction treatment providers. Statistical testing demonstrated that the quality measures were reliable and valid. The quality measure scores varied among providers, capturing a wide performance range. A public website containing quality measures launched in July 2020 in the six states and has been accessed by thousands of consumers. CONCLUSIONS: This study developed valid, reliable, and useful addiction treatment quality measures. Dissemination of these measures may help consumers select among providers and help providers, policy makers, and payers improve quality.

Risk Adjustment, Mode Adjustment, and Nonresponse Bias Analysis on Quality Measures From a Long-Term Care Hospital Experience of Care Survey.

OBJECTIVES: To develop a patient risk adjustment model for experience of care (EOC) quality measures for long-term care hospitals (LTCHs) that includes mode of survey administration. To assess presence of nonresponse bias in the adjusted facility-level scores. DESIGN: We tested 3 modes of collecting the EOC data: mail-only, mixed (ie, mail with telephone follow-up), and in-facility. This study used sequential modeling and impact analysis, specified a risk and mode adjustment model, and evaluated presence of nonresponse after adjustment. SETTING: LTCHs. PARTICIPANTS: Patients (N=1364) and 69 LTCHs. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Risk and mode adjusted responses to 28 survey questions and 6 facility-level scores derived from survey responses. RESULTS: Mode of data collection and patient risk variables (age, sex, overall health, overall mental health, marital status, education, race, and whether a proxy responded) were included in the model. Clinical variables were not significant. The in-facility mode was associated with significantly higher performance scores than the other modes. When the recommended risk and mode adjustment model was applied, nonresponse bias was not observed in any mode. CONCLUSIONS: LTCH EOC data should be adjusted for patient risk variables including mode of data collection.