Shatterproof is developing a free, web-based platform that will enable the public to locate addiction treatment facilities and better understand the core components of quality addiction treatment. It will also arm treatment programs with data and information that can be used to guide quality improvement efforts.
As a provider of addiction treatment, you are on the front lines addressing the nation’s addiction and opioid epidemic. You know the challenges and barriers of this space, as well as the incredible impact you have on the lives of those suffering with substance use disorders (SUDs). Providers across all levels of care and settings have been engaged in the development of ATLAS™ and have shaped our approach, implementation plan, and metrics. Ongoing collaboration with addiction treatment providers is critical to the success of this project.
As we shift toward implementation, we are looking to providers in the states involved in the first phase of this project to continue to shape it, provide input, and identify areas where technical assistance is needed. Your interest in and commitment to quality improvement, and your engagement in this project, have the potential to transform the addiction treatment system.
Why is ATLAS Important?
We know addiction can be managed similarly to other chronic diseases, but the use of evidence-based best practices varies widely across the addiction treatment field. We want to bring greater transparency to the field, not only to support patients in choosing the treatment that is right for them, but to incentivize and reward best-practices and improve the overall system.
Quality reporting platforms operating in other healthcare and commercial sectors show us the positive impacts of standardized measurement when it comes to driving quality improvement and adoption of best practices. No standardized measurement system exists for addiction treatment and we want to change that.
ATLAS is based on the Shatterproof National Principles of Care©, and will begin to standardize measurement of addiction treatment across all levels of care and types of treatment.
How will data on programs be displayed?
ATLAS will integrate data from multiple sources into data dashboards displaying key information that can be used to understand services provided and to compare treatment facilities. This information will be made available via a free, public website for those seeking treatment for themselves or a loved one. This website will also serve as a valuable resource for treatment providers and other referral sources such as drug courts, guidance counselors, policymakers, and payers searching for accurate information on high-quality facilities in their region.
Individuals using the ATLAS website will be able to filter search results by features that are important to them, such as location and insurance coverage. The website will also provide transparent information about whether facilities offer services aligned with evidence-based best practices shown to improve patient outcomes. Patients will also be allowed to report their own experiences with addiction treatment facilities. Click here for updates from June 2019 regarding how information will display in ATLAS, including the determination that there will not be a composite score in this first phase.
In addition to the public-facing platform, there will be password-protected portals for providers, payers, and states. Providers will be able to access their facility’s data and compare themselves against industry data, aiding them in targeting quality improvement efforts. Payers can use their portal to access data about programs in their network, potentially to recognize and incentivize better performance. States can use their portal to access data to inform treatment access capacity-building and other state-based initiatives, such as provision of technical assistance.
The first phase – a multi-state pilot
ATLAS is being pilot-tested in a select group of states in 2019-2020. States were chosen based on several criteria, including capacity for successful implementation of the pilot and demonstrated potential to scale ATLAS after the pilot. Following successful completion of the two-year pilot, ATLAS will be scaled nationwide.
At this time, ATLAS will examine specialty addiction treatment facilities that have been identified in partnership with pilot states. This includes residential, inpatient, outpatient, and opioid treatment programs. ATLAS does not include individual physicians or providers treating SUD.
Shatterproof received $5 million in funding for the development and implementation of the first phase of ATLAS and would like to thank Arnold Ventures and the Robert Wood Johnson Foundation for their generous support, as well as a group of six national healthcare companies.
We are thrilled to partner with state agencies, including Departments of Medicaid, Public Health, and Mental Health, and other large state stakeholders for this important initiative. Our state partners have committed to analyze their Medicaid data to inform ATLAS, encourage and leverage providers to self-report facility information, and work with Shatterproof to increase public awareness of the project.
The data and metrics
ATLAS is being developed and implemented by Shatterproof and the analytics contractor, RTI International (RTI), in partnership with pilot states and engaged payers.
RTI, an independent research institute, currently supports five national health quality reporting efforts and one large private rating system. RTI has developed and obtained National Quality Forum (NQF) endorsements for over 40 quality measures that use data from provider assessments, claims, and consumer surveys. RTI leads large-scale quality measure collection efforts with healthcare providers including supporting over 3,000 providers in reporting measures for the Centers for Medicare & Medicaid Services’ (CMS’) Comprehensive Primary Care Plus (CPC+) project. RTI employs over 250 staff focused on substance use research, including addiction psychiatrists, former behavioral health directors, economists, epidemiologists, psychologists, and survey researchers.
The measure set to be used in the pilot was drafted by a committee of quality experts, revised through a series of focus groups with payers and providers of addiction treatment, and pressure tested by an expert panel and public comment period run by the National Quality Forum.
To ensure the system continues to be meaningful and keep up with the latest evidence and best practices, measures will evolve each year as new measures are introduced, and existing measures are further refined or retired.
ATLAS will utilize data from three sources: insurance claims, Treatment Facility Survey, and a patient experience survey (or crowd-sourcing). Shatterproof is utilizing a mixed-method approach to ensure ATLAS can capture as much quality information as possible, given the fragmentation of the addiction treatment system. ATLAS will display information at the physical facility level.
Payer-reported measures (both Medicaid and commercial) are used to assess quality in many other healthcare specialties. RTI is working with public and commercial payer partners to inform a small set of claims-based measures that focus on factors important to delivering high-quality addiction treatment.
Treatment Facility Survey
All addiction treatment facilities in pilot states will be asked to respond to an online survey, answering questions about the services they offer, the patients they serve, and how they operate when it comes to important factors such as coordinating patient care, providing timely access to care, and connecting patients with external support resources. Facility administrators can contact the RTI Help Desk for technical assistance at any time.
Shatterproof, pilot states, and the involved payers are working to ensure that this process aligns as best as possible with current facility data collection efforts, with the aim that in the future it may reduce the need to report similar data to multiple stakeholders. ATLAS will also display accreditations or certifications, although this is not required to participate.
To ensure accuracy of the Treatment Facility Survey responses, there will be validation questions and analyses, an attestation, and random checks in the form of additional questions or documentation review for select programs. Data from alternative sources will also be used to validate self-reported information when feasible: for example, triangulating from claims data. Facilities that do not respond to the survey will still be listed on the ATLAS website, with an indication that this quality data is not available.
Patient experience survey
The patient experience approach currently being tested for this first phase of the project enables ATLAS to collect and report timely information from patients without placing burden on providers to field surveys. The online patient experience survey uses validated metrics developed and tested by the Agency for Healthcare Research and Quality. Each of the questions included in the survey were reviewed and subsequently recommended from a process run on Shatterproof’s behalf by the National Quality Forum in spring of 2019.
ATLAS will give treatment facilities the opportunity to compare themselves to other facilities throughout the state, target their quality improvement efforts in a more meaningful way, and stand out to patients seeking treatment. Providers may also be able to leverage their participation to secure enhanced reimbursement from their contracted payers.
We hope that you will take part in our engagement activities at the state level to help shape and build this groundbreaking platform. Shatterproof is committed to this being a collaborative effort. Participating during the pilot phase allows you to provide input on the design and impact of ATLAS. Your feedback early in the process will shape the structure of ATLAS so that it best serves your needs and the needs of all stakeholders, including the public, payers, and states in directing resources, supporting providers, and identifying top performers.
Providers in pilot states are in a unique position to help develop the foundation upon which we can create national standardized quality goals and a culture of continuous quality improvement throughout the industry.
Shatterproof is working with state partners and commercial payers to develop strategies that incentivize and reward participation in ATLAS (i.e. responding to the Treatment Facility Survey), such as highlighting early adopters. In some cases, these groups have also signaled that now or in the future reporting to ATLAS may be a requirement for eligibility for higher network tiers or alternative payment models, or to contract with Medicaid.
If you are a provider in the select group of states piloting ATLAS, and you are interested in helping to shape its design and rollout, we invite you to participate in the regular ‘Provider Roundtables’ taking place in your state. These virtual or in-person events offer updates and provide an opportunity for feedback. For more information on activities in your state, please contact ATLAS@Shatterproof.org with your name, facility location(s), and contact information.
- Data collection for the Treatment Facility Survey will begin in October 2019
- The survey results and claims data will be analyzed during Q1 of 2020
- ATLAS will go live on July 21, 2020, with a provider preview period in advance for user testing and to allow you to contest any potential errors.
For inquiries, please contact the Shatterproof National Treatment Quality Initiatives team at ATLAS@Shatterproof.org
For answers to many more frequently asked questions, click here.
To learn more about Shatterproof’s other work, including advocacy efforts and patient education, we invite you to explore our website.