The ACA expands coverage for substance use treatment, but provides no measures for assessing its quality.

The Affordable Care Act

An Opportunity for Improving Care for Substance Use Disorders?

Published In: Psychiatric Services, v. 66, no. 3, Mar. 2015, p. 310-312

Posted on RAND.org on December 08, 2014

by Katherine E. Watkins, Carrie M. Farmer, David De Vries, Kimberly A. Hepner

Research Question

  1. Are existing quality measures adequate to assess quality of care for substance use disorders?

The Patient Protection and Affordable Care Act (ACA) will greatly increase coverage for treatment of substance use disorders. To realize the benefits of this opportunity, it is critical to develop reliable, valid, and feasible measures of quality to ensure that treatment is accessible and of high quality. The authors review the availability of current quality measures for substance use disorder treatment and conclude there is a pressing need for development, validation, and use of quality measures. They provide recommendations for research and policy changes to increase the likelihood that patients, families, and society benefit from the increased coverage provided by the ACA.

Key Findings

  • Existing quality measures for substance use treatment are sparse, of limited scope, and do not reflect the current science about treatment effectiveness.
  • The few measures that have been endorsed have not been strongly linked to clinical outcomes.
  • The Affordable Care Act (ACA) could expand coverage for substance abuse treatment without providing measures to assess the quality of care.

Recommendation

  • Reaping the benefits of expanded coverage under the ACA will require developing quality measures for substance use treatment.
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