September 2013
The overall goal of the Brandeis-Maine Study is to obtain a better understanding of the effects of financial incentives within addiction treatment programs. The study focuses on outpatient (OP) and intensive outpatient (IOP) substance abuse treatment agencies for adults that are paid under Maine’s incentivized contract. Agencies that do not receive SAMHS funding will serve as a comparison group.
Who is conducting the study?
The study is being conducted by researchers at the Institute for Behavioral Health at Brandeis University, in collaboration with the Maine Office of Substance Abuse and Mental Health Services and with input from Maine’s Association of Substance Abuse Providers and others. The study is funded by the National Institute on Drug Abuse (NIDA). It will be conducted over the course of 5 years.
Why are you conducting the study?
Maine addiction treatment agencies and providers have extensive experience with financial incentives which is valuable to Maine agencies, providers elsewhere, policy-makers and states as they think about ways to improve the quality of addiction services. Through this study we hope to learn from those who are involved in the Maine experience to develop an understanding of the mechanisms that agencies have used to respond to incentives, as well as the benefits and consequences of incentive approaches.
What are the specific goals of the study?
The overall goal is to obtain a better understanding of the effects of financial incentives within addiction treatment programs and to see if additional incentives paid to direct care staff have added effects. The study focuses on outpatient and intensive outpatient addiction treatment programs paid under Maine’s incentivized contract (also known as a performance-based contract). Programs that do not receive SAMHS funding will serve as a comparison group, as their approaches to quality improvement are also valuable to understand. The study will address the following questions in phase one:
- How have quality of care and outcomes changed since implementation of the incentivized contract?
- What, if any, were the positive or negative unintended effects of the incentivized contract?
- How did program managers adapt their programs in order to implement the incentivized contract, and what are barriers or facilitators to achieving the contract’s goals?
- What were the clinicians’ roles in adapting to and meeting the performance measures?
A second phase will examine whether additional financial incentives paid to front-line staff and clinicians influence agency performance.
What will the researchers want from me?
Researchers from Brandeis University will contact program directors for in-person or telephone interviews and a brief online survey beginning in Fall 2013. Clinicians and front-line staff will be asked to complete online surveys so we can gain their perspective on how performance-based contracting and the use of incentives affect their work.
Participation is voluntary; please note that all interviews and surveys are completely confidential and results will only be shared with SAMHS when aggregated across all programs. Additional data will come from the SAMHS Treatment Data System (TDS). Changes are not being made to the incentivized contract to conduct the study.
What impact will the study have?
Performance-based contracts are still a relatively new and little-studied approach in addiction treatment and much is unknown about their success and their challenges. Results from this study therefore offer valuable contributions to both treatment and research communities, especially as states continue to adopt different strategies to improve care. The Maine project is a unique opportunity for a state agency, treatment providers, and a university to work together to examine approaches to improving treatment and outcomes. Results will support policymakers in Maine, other states, the federal government and insurers as they consider financial incentives to support delivery of high quality addiction treatment.
Who can I contact if I have questions about this project?
Maureen Stewart at Brandeis University, mstewart@brandeis.edu, 781-736-3717
Sharon Reif at Brandeis University, reif@brandeis.edu, 781-736-3924
Stacey Chandler at SAMHS, stacey.chandler@maine.gov, 207-287-6337
Brandeis University Institutional Review Board (IRB), irb@brandeis.edu, 781-736-8133
Key Project Staff (Brandeis University)
Sharon Reif, Principal Investigator, reif@brandeis.edu, 781-736-3924
Maureen Stewart, Project Manager and Co-Investigator, mstewart@brandeis.edu, 781-736-3717
Margot Davis, Lead Interviewer and Co-Investigator, margotd@brandeis.edu, 781-736-3850
Maria Torres, Interviewer and Co-Investigator, mtorres@brandeis.edu, 781-736-4836