The Heller School for Social Policy and Management
Brandeis-Harvard SPIRE Center

Quality Measurement in the Treatment of Substance Use Disorders: The Role of Social Risk Factor Adjustment

On February 9th, 2024, the SPIRE Center hosted a Spring Methods Seminar with Dr. David Shahian addressing the role of social risk factor adjustment in quality measurement for SUD treatment. In addition to practicing for decades as a cardiac surgeon and department chair, Dr. Shahian is a leader in quality measurement and public reporting. 

The following references were provided by Dr. Shahian for further insight into quality measurement in SUD treatment.

  1. Committee on Accounting for Socioeconomic Status in Medicare Payment Programs, Board on Population Health and Public Health Practice, Board on Health Care Services, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Accounting for Social Risk Factors in Medicare Payment. (Kwan LY, Stratton K, Steinwachs DM, eds.). National Academies Press; 2017:23635. doi:10.17226/23635
  2. Committee on Accounting for Socioeconomic Status in Medicare Payment Programs, Board on Population Health and Public Health Practice, Board on Health Care Services, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Accounting for Social Risk Factors in Medicare Payment: Criteria, Factors, and Methods. National Academies Press; 2016:23513. doi:10.17226/23513
  3.  Committee on Accounting for Socioeconomic Status in Medicare Payment Programs, Board on Population Health and Public Health Practice, Board on Health Care Services, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Accounting for Social Risk Factors in Medicare Payment: Data. National Academies Press; 2016:23605. doi:10.17226/23605
  4. Committee on Accounting for Socioeconomic Status in Medicare Payment Programs, Board on Population Health and Public Health Practice, Board on Health Care Services, Institute of Medicine, National Academies of Sciences, Engineering, and Medicine. Accounting for Social Risk Factors in Medicare Payment: Identifying Social Risk Factors. National Academies Press; 2016:21858. doi:10.17226/21858
  5. Joynt Maddox KE, Reidhead M, Hu J, et al. Adjusting for social risk factors impacts performance and penalties in the hospital readmissions reduction program. Health Services Research. 2019;54(2):327-336. doi:10.1111/1475-6773.13133
  6. Watkins KE, Paddock SM, Hudson TJ, et al. Association between process measures and mortality in individuals with opioid use disorders. Drug and Alcohol Dependence. 2017;177:307-314. doi:10.1016/j.drugalcdep.2017.03.033
  7. Hepner KA, Paddock SM, Watkins KE, Ounpraseuth ST, Schrader AM, Hudson TJ. Association Between Quality Measures and Perceptions of Care Among Patients With Substance Use Disorders. PS. 2017;68(11):1150-1156. doi:10.1176/appi.ps.201600484
  8. Joynt Maddox KE, Reidhead M, Qi AC, Nerenz DR. Association of Stratification by Dual Enrollment Status With Financial Penalties in the Hospital Readmissions Reduction Program. JAMA Intern Med. 2019;179(6):769. doi:10.1001/jamainternmed.2019.0117
  9. Watkins KE, Pincus HA, Paddock S, et al. Care For Veterans With Mental And Substance Use Disorders: Good Performance, But Room To Improve On Many Measures. Health Affairs. 2011;30(11):2194-2203. doi:10.1377/hlthaff.2011.0509
  10. Mehaffey JH, Hawkins RB, Charles EJ, et al. Distressed communities are associated with worse outcomes after coronary artery bypass surgery. The Journal of Thoracic and Cardiovascular Surgery. 2020;160(2):425-432.e9. doi:10.1016/j.jtcvs.2019.06.104
  11. Evaluation of the NQF Trial Period for Risk Adjustment for Social Risk Factors. National Quality Forum; 2017.
  12. Vink JM. Genetics of Addiction: Future Focus on Gene × Environment Interaction? J Stud Alcohol Drugs. 2016;77(5):684-687. doi:10.15288/jsad.2016.77.684
  13. Tipton K, Leas BF, Flores E, et al. Impact of Healthcare Algorithms on Racial and Ethnic Disparities in Health and Healthcare. Agency for Healthcare Research and Quality (AHRQ); 2023. doi:10.23970/AHRQEPCCER268
  14. Patrick WL, Bojko M, Han JJ, et al. Neighborhood socioeconomic status is associated with differences in operative management and long-term survival after coronary artery bypass grafting. The Journal of Thoracic and Cardiovascular Surgery. 2022;164(1):92-102.e8. doi:10.1016/j.jtcvs.2020.08.024
  15. Ciraulo DA, Piechniczek-Buczek J, Iscan EN. Outcome predictors in substance use disorders. Psychiatric Clinics of North America. 2003;26(2):381-409. doi:10.1016/S0193-953X(02)00106-5
  16. Hirsch H, Wheeler N, Gelman K, Swan J. Outcomes Measurement Toolkit and Pilot Program Final Report. National Association of Addiction Treatment Providers; 20019:1-87. https://www.naatp.org/sites/naatp.org/files/OutcomesToolkitandReport.pdf
  17. Reske M, Paulus MP. Predicting Treatment Outcome in Stimulant Dependence. Annals of the New York Academy of Sciences. 2008;1141(1):270-283. doi:10.1196/annals.1441.011
  18. Pincus HA, Scholle SH, Spaeth-Rublee B, Hepner KA, Brown J. Quality Measures For Mental Health And Substance Use: Gaps, Opportunities, And Challenges. Health Affairs. 2016;35(6):1000-1008. doi:10.1377/hlthaff.2016.0027
  19. Stone AL, Becker LG, Huber AM, Catalano RF. Review of risk and protective factors of substance use and problem use in emerging adulthood. Addictive Behaviors. 2012;37(7):747-775. doi:10.1016/j.addbeh.2012.02.014
  20. Fiscella K, Nerenz DR, Accius J. Risk Adjustment for Socioeconomic Status or Other Sociodemographic Factors. National Quality Forum; 2014.
  21. Second Report to Congress on Social Risk Factors and Performance in Medicare’s Value-Based Purchasing Program. Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health & Human Services.; 2020. https://aspe.hhs.gov/social-risk-factors-and-medicares-value-basedpurchasing-programs
  22. Joynt KE, De Lew N, Sheingold SH, Conway PH, Goodrich K, Epstein AM. Should Medicare Value-Based Purchasing Take Social Risk into Account? N Engl J Med. 2017;376(6):510-513. doi:10.1056/NEJMp1616278
  23. Fitzpatrick SL. Social Determinants of Health, Social Risks, and Social Needs: What’s the Difference and How Do You Measure Them? Published online 2022. https://www.sbm.org/publications/outlook/issues/summer-2022/social-determinants-of-health-social-risks-social-needs-whats-the-difference-how-do-you-measure-them/full-article
  24. Joynt KE, Zuckerman R, Epstein AM. Social Risk Factors and Performance Under Medicare’s Value-Based Purchasing Programs. Circ: Cardiovascular Quality and Outcomes. 2017;10(5):e003587. doi:10.1161/CIRCOUTCOMES.117.003587
  25. Charles EJ, Mehaffey JH, Hawkins RB, et al. Socioeconomic Distressed Communities Index Predicts Risk-Adjusted Mortality After Cardiac Surgery. The Annals of Thoracic Surgery. 2019;107(6):1706-1712. doi:10.1016/j.athoracsur.2018.12.022
  26. Schmidt EM, Liu P, Combs A, Trafton J, Asch S, Harris AHS. Surveying the Landscape of Quality-of-Care Measures for Mental and Substance Use Disorders. PS. 2022;73(8):880-888. doi:10.1176/appi.ps.202000913
  27. Committee on Accounting for Socioeconomic Status in Medicare Payment Programs, Board on Population Health and Public Health Practice, Board on Health Care Services, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Systems Practices for the Care of Socially At-Risk Populations. National Academies Press; 2016:21914. doi:10.17226/21914
  28. Ventrell M, Thomas P, Dunn M, et al. The Addiction Treatment Provider Quality Assurance Guidebook. National Association of Addiction Treatment Providers; 2019:1-48. https://www.naatp.org/sites/naatp.org/files/QualityAssuranceGuidebook.pdf
  29. Patel MM, Brown JD, Croake S, et al. The Current State of Behavioral Health Quality Measures: Where Are the Gaps? PS. 2015;66(8):865-871. doi:10.1176/appi.ps.201400589
  30. Prom-Wormley EC, Ebejer J, Dick DM, Bowers MS. The genetic epidemiology of substance use disorder: A review. Drug and Alcohol Dependence. 2017;180:241-259. doi:10.1016/j.drugalcdep.2017.06.040