Decades of research prove that addiction can be treated with the same effectiveness as other chronic diseases, like diabetes or hypertension. But unlike these other conditions, addiction is heavily stigmatized, and the quality of addiction treatment programs across the United States varies widely. 

While some programs offer evidenced-based and clinically effective medical treatment, others employ tactics based on folklore, beliefs, or ineffective and outdated methodologies. These programs are harmful. They perpetuate stigma and misconceptions about addiction, and in some cases, their practices are even criminal. And tragically for patients and family members seeking care, it is nearly impossible to sort the high-quality programs from those that may do more harm than good.

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Shatterproof’s Rating System for Addiction Treatment Programs will cut through the confusion for families in need, delivering trustworthy, standardized information about the levels and quality of care offered at all types of treatment centers. It will drive improvement among treatment programs by increasing accountability and transparency, and it will supply states and health care payers with the information necessary to reward high-quality care.

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How it works

Shatterproof’s new rating system will display transparent and trustworthy information about addiction treatment programs. It will show whether or not each program offers services that align with proven, evidence-based best practices outlined in our Principles of Care©

The system will allow the public to report on their experiences with addiction treatment programs. It will be searchable by location, insurance provider, quality, and other factors that are important to the public. The system will be easy for the public to understand, and it will be free for them to use.

The system will also feature password-protected portals for programs, payers, and states. Within their portal, addiction treatment programs can access their own data, which will be benchmarked against industry data to drive quality improvement. Payers can use their portal to access data about programs in their network to financially incentivize better performance. States can use their portal to access data to inform treatment access and other state-based initiatives, such as technical assistance. The system will incentivize change and improvement among treatment programs by increasing accountability.

Our approach

Our approach to this system builds on best practices used by rating websites in healthcare and other industries and will provide reliable and valid information in a user-friendly way.

Publicly available health quality reporting has been in existence in the U.S. since 1987, when the Health Care Financing Administration, now the Centers for Medicare and Medicaid Services (CMS), released nationwide hospital-specific mortality data. Following controversy over the public release of this information, efforts for improvement began, and quality reporting models started to evolve. Now, there are hundreds of reporting initiatives focused on a variety of healthcare services and settings and using a range of methodologies. Building off of lessons learned from decades of health quality reporting, Shatterproof has developed an approach that overcomes the limitations of past systems in order to efficiently collect and report accurate, comprehensive data.

The Shatterproof Rating System for Addiction Treatment Programs will utilize data from three sources: insurance claims, treatment program surveys, and consumer experience. Our treatment program surveys will ask treatment programs to self-report on a variety of data. Programs that do not respond to the survey will still be listed on the Rating System website, with an indication that this quality data is not available.

We are using a mixed-method approach to ensure we can capture as much quality information as possible, given the fragmentation of the addiction treatment system. Importantly, this system will examine treatment programs offering all substance use disorder treatment, not just those who offer treatment for opioid use disorder. While some of the system’s measures are specific to opioid use disorder, those will be marked as such.

Pilot Scope

This project will be piloted in a select number of states before expanding nationally. We are in in the process of finalizing which states will be included and will provide updates when the pilot states are officially chosen. We will select the pilot states based on a number of criteria, including likelihood of ensuring the success of the pilot, and demonstrated potential to scale the rating system after the pilot.

Pilot Audiences

The pilot will be geared toward multiple audiences. It will be used by individuals looking for high-quality addiction treatment for themselves or a loved one. It will also be used by treatment programs, payers, states and referral sources.

During the pilot period, the Rating System will be free to all users, including treatment programs and payers.

Funding

This roughly $5 million project is being led by Shatterproof and is supported by Arnold Ventures and the Robert Wood Johnson Foundation, as well as a group of health insurers: Aetna, a CVS Health business, Anthem, Inc., Beacon Health Options, Cigna, Magellan Health, and UnitedHealth Group. 

Analytics Partner

Our analytics partner in the Shatterproof Rating System is RTI International. RTI is an independent research institute with national expertise in quality measurement and substance use disorders. RTI 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 data, 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.

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