Implementation of Client Incentives within a Recovery Navigation Program

Brolin, Mary; Torres, Maria; Hodgkin, Dominic; Horgan, Constance M.; Lee, Margaret; Merrick, Elizabeth L.; Ritter, Grant; Panas, Lee; DeMarco, Natasha; Hopwood, Jonna; Gewirtz, Andrea; Straus, John H.; Harrington, Janice N.; Lane, Nancy E.

doi:10.1016/j.jsat.2016.09.003

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…Given the importance of continuity of care after residential treatment and detox in combination with our findings that neither incentives nor electronic reminders are effective interventions (except for in agencies with higher baseline continuity of care), it is important to consider multiple, perhaps simultaneous, approaches to support quality improvement efforts at the agency level. Other promising interventions include client-level incentives (Rash et al, 2017), client support through recovery coaches (Brolin et al, 2017), provider training in motivation enhancement (Timko et al, 2015) and discharge planning, providing transportation (Ford and Zarate, 2010) or accompanying patients to the next level of care (Carroll et al, 2009; Timko et al, 2016). Developing relationships with a network of service delivery agencies to increase the number of treatment settings to which an agency could refer its clients may also increase the number of patients receiving treatment (Spear, 2014).…”

Section: Discussionmentioning

confidence: 99%

Agency-level financial incentives and electronic reminders to improve continuity of care after discharge from residential treatment and detoxification

Acevedo

Lee

Garnick

et al. 2018

Drug and Alcohol Dependence

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Section: Discussionmentioning

confidence: 99%

Agency-level financial incentives and electronic reminders to improve continuity of care after discharge from residential treatment and detoxification

Acevedo

Lee

Garnick

et al. 2018

Drug and Alcohol Dependence

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“…RSNs provided CSP-like services with a few notable differences. All RSNs completed an initial training and participated in monthly in-person coaching sessions and quarterly trainings as part of a larger study, described elsewhere [ 19 ]. Organizations providing RSN services were paid a daily case rate for each client on RSNs’ caseloads, and RSNs had no restrictions on the type or volume of services they provided to clients.…”

Section: Methodsmentioning

confidence: 99%

Evaluating the feasibility and impact of case rate payment for recovery support navigator services: a mixed methods study

Torres

Brolin

Panas

et al. 2020

BMC Health Serv Res

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Background Acute 24-h detoxification services (detox) are necessary but insufficient for many individuals working towards long-term recovery from opiate, alcohol or other drug addiction. Longer engagement in substance use disorder (SUD) treatment can lead to better health outcomes and reductions in overall healthcare costs. Connecting individuals with post-detox SUD treatment and supportive services is a vital next step. Toward this end, the Massachusetts Medicaid program reimburses Community Support Program staff (CSPs) to facilitate these connections. CSP support services are typically paid on a units-of-service basis. As part of a larger study testing health care innovations, one large Medicaid insurer developed a new cadre of workers, called Recovery Support Navigators (RSNs). RSNs performed similar tasks to CSPs but received more extensive training and coaching and were paid an experimental case rate (a flat negotiated reimbursement). This sub-study evaluates the feasibility and impact of case rate payments for RSN services as compared to CSP services paid fee-for-service. Methods We analyzed claims data and RSN service data for a segment of the Massachusetts Medicaid population who had more than one detox admission in the last year and also engaged in post-discharge CSP or RSN services. Qualitative data from key informant interviews and Learning Collaboratives with CSPs and RSNs supplemented the findings. Results Clients receiving RSN services under the case rate utilized the service significantly longer than clients receiving CSP services under unit-based billing. This resulted in a lower average cost per member per month for RSN clients. However, when calculating total SUD treatment costs per member, RSN client costs were 50% higher than CSP client costs. Provider organizations employing RSNs successfully implemented case rate billing. Benefits included allowing time for outreach efforts and training and coaching, activities not paid under the unit-based system. Yet, RSNs identified staffing and larger systems level challenges to consider when using a case rate payment model. Conclusions Addiction is a chronic disease that requires long-term investments. Case rate billing offers a promising option for payers and providers as it promotes continued engagement with service providers. To fully realize the benefits of case rate billing, however, larger systems level changes are needed.

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“…Another paper in this special issue by Brolin et al (2017) describes a study conducted in Massachusetts that had a similar intent - in this case to improve outcomes for SUD patients with multiple prior detoxification admissions. The paper examines cost and behavior outcomes for participants assigned to receive a care support intervention with and without incentives.…”

Section: Extensions To Other Health Behaviorsmentioning

confidence: 99%

Contingency Management: New Directions and Remaining Challenges for An Evidence-Based Intervention

Rash

Stitzer

Weinstock

2017

Journal of Substance Abuse Treatment

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This article introduces the special issue on contingency management (CM), an efficacious intervention for the treatment of substance use disorders with low uptake in clinical settings that is not commensurate with evidence for efficacy. In this special issue of the Journal of Substance Abuse Treatment, we present 16 articles representing the latest research in efficacy, implementation, and technological advances related to CM. Combined, this collection of articles highlights the diverse populations, settings, and applications of CM in the treatment of substance use disorders. We conclude by highlighting directions for future research, particularly those that may increase CM’s appeal and uptake in routine clinical care.

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Implementation of Client Incentives within a Recovery Navigation Program

Cited by 5 publications

References 13 publications

Agency-level financial incentives and electronic reminders to improve continuity of care after discharge from residential treatment and detoxification

Agency-level financial incentives and electronic reminders to improve continuity of care after discharge from residential treatment and detoxification

Evaluating the feasibility and impact of case rate payment for recovery support navigator services: a mixed methods study

Contingency Management: New Directions and Remaining Challenges for An Evidence-Based Intervention

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