Not heard of ATLAS? I think you’ll be hearing more soon.
Shatterproof is national non-profit focused on reversing the course of addiction crisis throughout the U.S. They set out to develop a system that evaluates the quality of addiction treatment provider organizations. Originally called a rating system, Shatterproof recently renamed the system ATLAS in preparation for the public facing launch in 2020 and to emphasize that the tool will focus on improving quality over creating ratings (see Shatterproof Launching Addiction Treatment Rating System). Announced in December 2018, over the first half of 2019, Shatterproof has been working diligently to design the model, select pilot states, and meet with the stakeholders (see Five States To Pilot The Shatterproof Addiction Treatment Rating System).
This isn’t just another system collecting data, its important because payers and health plans are getting onboard including Aetna (a CVS Health business), Anthem, Inc., Beacon Health Options, Cigna, Magellan Health, and UnitedHealth Group. To learn more about the new addiction treatment locator, analysis and standards tool, now known as ATLAS, we sat down with Samantha Arsenault, MA, Vice President of National Treatment Quality Initiatives, Shatterproof, and Eric Bailly, LPC, LADC, Business Solutions Director, Anthem, Inc. and Doug Nemecek, M.D., MBA, Chief Medical Officer – Behavioral Health, Cigna.
Ms. Arsenault started out by explaining a little about ATLAS, which will feature a publicly available dashboard where individuals seeking treatment and their families can view quality data, as well as password protected portals for treatment provider organizations to view their own data and states and payers to access the dashboard. The focus of the system is not rating provider organizations, but bringing transparency to the use of best practices that indicate high-quality and to drive and support quality improvement. For this reason, there will be no composite score in the first phase of the project.
The measures selected for the program were refined and selected with help from provider organizations and through input from a National Quality Forum Expert Panel and cover structure, process, outcome, and patient experience categories. Examples of measures include:
- Evidence of opioid use disorder (OUD) medication use among patients with OUD treated at this program: Individuals with an OUD diagnosis that have medical or pharmacy claims for an FDA-approved medication specific to OUD treatment.
- During your treatment, were you given information about different kinds of counseling or treatment that are available?
- Continuous adjustments to treatment (measurement-based care): Does the program apply standardized assessments over time to determine treatment progress? If so, what outcomes are measured? How frequently are they measured? What instruments are used to measures outcomes?
Mr. Bailly and Dr. Nemecek talked about why their organizations decided to get behind the ATLAS. Both noted that their organizations want to ensure that people have access to and can find quality treatment. Dr. Nemecek explained:
Our objective is to help our customers identify and obtain the highest quality substance use disorder (SUD) treatment, so that they get the care they need to get well. The ATLAS will provide reliable, objective information about treatment options to help people get to the right treatment program at the right time.
Mr. Bailly explained:
We have a strong emphasis on connecting to high quality services. Services based in the evidence, high quality outcomes, and value-based reimbursement is one way to do that. Shatterproof is one of those irons in the fire. It has a national impact that will include all Anthem markets.
At this point in time, Mr. Bailly and Dr. Nemecek both noted that it is too early to tell how the Shatterproof rating system will be included in their provider certification and rating process. Mr. Bailly noted that they are interested in comparing the data on the Shatterproof site to what they can mine from their claims data and then sharing that comparison back with Shatterproof to confirm accuracy. He also noted that Anthem is working with the Blue Cross and Blue Shield Association’s Blue Distinction Centers to help identify centers of excellence for substance use disorder treatment. Both efforts assist in guiding members to high quality SUD treatment. Dr. Nemecek said that right now Cigna is very interested at getting this data into the hands of their members and ensuring that they are driven to high quality care.
At this point in time Mr. Bailly and Dr. Nemecek both noted that it is too early to tell how the Shatterproof quality measurement system will be included in their provider certification and rating process. Mr. Bailly noted that they are interested in comparing the data on the Shatterproof site to what they can mine from their claims data. He also noted that this may factor into Anthem’s Blue Distinction program which identifies centers of excellence. Dr. Nemecek said that right now Cigna is very interested at getting this data into the hands of their members and ensuring that they are driven to high quality care.
For provider organizations they had some distinct advice. The creation of ATLAS enforces an emphasis on the use of evidence-based best practices and the trend towards value-based reimbursement and measurement-based care. Provider organizations need to ensure that they can internally track quality measures and use those measures to drive change in their organization. The idea here is not to add additional reporting burden but to create a set of agreed upon measures for the addiction treatment market. Health plans, payers, and increasingly the public, are going to be demanding demonstrated outcomes. Ms. Arsenault noted that Shatterproof wants to help provider organizations make this change. Shatterproof has developed crosswalks and educational materials to help provider organizations make the change.
To learn more about the Shatterproof model and the effect it is likely to have on provider organizations, join Ms. Arsenault, Mr. Bailly, and Dr. Nemecek at The 2019 OPEN MINDS Management Best Practices Institute for their keynote address: “Quality Measurement In Addiction Treatment: Advancing Adoption Of Best Practices”.