Performance measures for substance use disorders – what research is needed?

Two decades ago, the Institute of Medicine defined quality as “the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” [1]. Today, performance measures, the metrics used to measure the quality of healthcare, play increasingly important roles in all aspects of healthcare.In particular, the increased focus on performance measures that address the prevention and treatment of substance use disorders has been driven by new legislative initiatives. The 2010 Patient Protection and Affordable Care Act has the potential to open up treatment for substance use disorders to more Americans. The 2008 Mental Health Parity and Addiction Equity Act expands benefits for mental and substance use disorders. The Health Information Technology for Economic and Clinical Health Act (HITECH Act) encourages the promulgation of electronic health records and incentives for performance measurement. In addition, widespread payment reforms, including incentive–based approaches, are leading to an ever stronger focus on the accountability of clinicians and treatment programs for providing high quality services.Given the high stakes uses of performance measures, it is crucially important that performance measures focused on substance use disorders be further developed, be critically examined, and be implemented in the context of a changing health care system [2]. Therefore, in March 2010, the Washington Circle convened a meeting of payers, consumers, providers, policy makers and researchers to discuss the state of performance measures and to develop a research agenda to address current deficits. The Washington Circle is a group of national experts on substance abuse policy, research, and performance measurement that seeks to improve the quality and effectiveness of prevention and treatment services through the use of performance measures [3]. This meeting was supported by the Su