Table 1 Summary of health reform readiness index categories, conditions and indicators

Condition

Score and progression of reform readiness indicators (summary)

Patient/Family Role

0 = Patients and family are not involved in treatment decision-making.

1 = Patients and family are somewhat involved but clinicians make all decisions.

2 = Patients are actively involved in treatment decision-making and goal-setting; families are invited to some sessions/events.

3 = Patients and clinicians are full partners in treatment decision-making and goal-setting; families are involved in treatment sessions/events.

Evidence-Based Treatment

0 = Does not use National Quality Forum (NQF) practice standards.

0 = Does not use National Quality Forum (NQF) practice standards.

1 = Clinicians have access to prescribing medications and learning about NQF clinical interventions through training.

2 = Has on-staff prescribing capacity. Offers in-service training for NQF clinical interventions.

3 = On-staff prescribing capacity is widely used. Has in-service training and mechanisms for reviewing fidelity to NQF clinical interventions.

Accountability for Patient Care

0 = Documents care provided within organization over time.

1 = Documents care provided within organization and elsewhere – information shared by patient.

2 = Documents care provided within organization and elsewhere – information shared by patient and/or other healthcare organizations.

3 = Documents care provided within organization and elsewhere – information shared by patient and/or other healthcare organizations). Patient identifies organization as medical home.

Integrated Continuum of Care

0 = Offers a single level of care.

1 = Controls/has direct access to multiple levels of addiction or mental health care.

2 = Controls/has direct access to all levels of addiction and mental health care.

3 = Controls/has direct access to all levels of addiction, mental health, and primary care.

CATEGORY: YOUR ORGANIZATION

Board of Directors

0 = Board is uninformed about parity and health care reform.

1 = Board is informed about opportunities presented by parity and health care reform.

2 = Board is informed and supports staff efforts to take advantage of opportunities presented by parity/reform opportunities.

3 = Board assures all activities take advantage of opportunities presented by parity/reform in finance, operations, human resources, treatment quality, or programming

Workforce

0 = Has < 20% licensed clinicians.

1 = Has > 20% licensed clinicians. Patients have access to medical personnel.

2 = Has > 33% licensed clinicians and  > 10% staff are medical personnel.

3 = Has > 50% licensed clinicians and  > 15% staff can prescribe medications.

Patient Record

0 = Uses only paper records.

1 = Uses electronic records.

2 = Uses pre-formatted electronic records which integrates into data management and billing systems.

3 = Uses pre-formatted electronic records which integrates into data management and billing systems. Shares clinical information and patient registries electronically with other health care partners.

Holistic Care

0 = Provides only substance abuse treatment. Does not refer to other services.

1 = Provides only substance abuse treatment, and refers patients to primary care and support services.

2 = Provides substance abuse treatment, assesses patients’ physical and psychosocial health, and has formal agreements to refer patients to other services.

3 = Provides substance abuse treatment, assesses patients’ physical and psychosocial health, and can transfer patients and records to other health/support organizations.

Outcomes Measurement

0 = Collects data on dates and types of service.

1 = Collects data on dates, types of service, admissions and length of stay. Uses data for process improvement.

2 = Collects data on dates, types of service, admissions, length of stay and patient functioning during treatment. Uses data for process improvement.

3 = Collects data on dates, types of service, admissions, length of stay, patient functioning during treatment, and outcomes measures. Uses data for process improvement.

Quality Management

0 = Documents quality indicators. Does not have quality management staff.

1 = Documents quality indicators. A staff person monitors requirements for licensing, payer contracts and accreditation.

2 = Documents quality indicators. Monitors requirements for licensing, payer contracts and accreditation. Has a quality management officer and conducts regular quality reviews.

3 = Documents quality indicators. Monitors requirements for licensing, payer contracts and accreditation. Has a quality management officer. Conducts regular quality reviews, and has a culture of continuous improvement and high level of accreditation.

Patient Health Technology

0 = Does not collect data to use in treatment.

1 = Patients complete assessments using electronic media.

2 = Patients complete assessments, and have access to records and clinician communication using electronic media.

3 = Patients complete assessments, have access to records and clinician communication, and interactive support/ direction using electronic media.

Administrative Information Technology (IT)

0 = Has paper and/or electronic systems that do not interact.

1 = IT system collects and manages utilization and financial information for billing and accounting.

2 = IT system collects and manages utilization and financial information for billing and accounting, and links directly to billing system.

3 = IT system collects and manages utilization and financial information. Data system is integrated for management, billing, human resources, and clinical data.

Finance

0 = Revenue mostly from grants. Does not bill third-party payers.

1 = Up to 10% revenue comes from third-party payers. All services have unit costs.

2 = Up to 30% revenue comes from third-party payers. All services have unit costs, and organization has cash reserves up to 90 days.

3 = Up to 50% revenue from third-party payers. All services have unit costs, and organization has cash reserves up to 90 days.