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Promoting benchmarking in addiction treatment

April 1, 2009
by Paul M. Lefkovitz, PhD, Jay Ford, PhD, Becky Vaughn, and Richard Nance, MSW, MSHHA
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Three partners launch a national benchmarking initiative

These are unprecedented times in the field of addiction services. State capitals around the country are dealing with deep holes in their budgets by making serious, often draconian, cuts to human services. Advocates find themselves reeducating policy makers on the dire consequences of untreated addictions. Yet instead of pushing for much-needed increases in budget lines, providers are holding their breath, hoping to be held harmless. At the same time, the federal parity law is opening doors of opportunity while infusing new challenges. The sometimes trite phrase “only the strong survive” suddenly has become very real. As with any business, providers focused on quality and efficiency will be the leaders of tomorrow's industry.

In this unforgiving economic environment, addiction treatment providers must exhibit optimal financial, operational, and clinical performances to survive and thrive. Benchmarking represents a powerful yet underutilized management tool that can assist leaders in achieving an efficient operation to help survive today's environment. Benchmarking can answer critical and daunting questions such as:

  • How can our organization become more efficient?

  • Where is the financial “bleeding” in our programs?

  • What are the qualities of the most successful providers?

  • How can we maintain or even improve the quality of care while reducing our expenses?

  • How can we do “more” with “less”?

Without benchmarking, information available to addiction treatment leaders is of limited value. Consider how helpful a thermometer would be if it were not known that 98.6° is “normal.” Similarly, critical performance indicators, such as financial expenditures, productivity levels, no-show rates, staffing ratios, and the like, are not very useful in the absence of a context. Yet benchmarking provides that vital context and, in doing so, transforms “numbers” into actionable information. Gift and Mosel define benchmarking as “the continual and collaborative discipline of measuring and comparing the results of key work processes.”1 In fact, the “ultimate objective of benchmarking is to identify ‘best practices’ associated with high levels of performance and to see those practices find expression in organizational re-design and enhancement.”2

A national initiative

Very little exists in the way of accessible and affordable benchmarking data that have been targeted to the addiction treatment field. To address this void, three prominent national groups have partnered to launch a state-of-the-art benchmarking initiative specifically targeted to the addiction treatment field's unique needs. The State Associations of Addiction Services (SAAS, http://www.saasnet.org), NIATx (http://www.niatx.net), and Behavioral Pathway Systems (BPS, http://www.bpsys.org) have joined forces to establish the Benchmarking for Organizational Excellence in Addiction Treatment Initiative.

This initiative will place benchmarking tools into the hands of addiction treatment program leaders throughout the country. A comprehensive range of financial, operational, and clinical performance indicators will be featured, all focused on addiction treatment organizations. Readily available data will be submitted by participating organizations via a user-friendly, confidential, online survey. Individualized benchmarking reports will be generated that will compare the organization's performance against national norms. In-state comparisons also will be provided, assuming an adequate statewide sample size.

Easy-to-understand percentile rankings will reflect how the organization's performance compares with that of others. Comparisons will be broken out by budget size, geographic area served, and setting type to provide helpful “apples-to-apples” comparisons. This benchmarking model has been applied successfully in other areas of behavioral healthcare and human services.3

The initiative will provide opportunities to identify potential best practices and to learn from “top performers.” Both BPS and NIATx have developed unique formalized procedures for discerning potentially effective avenues for process improvement. At a broader level, the benchmarking initiative will provide essential data needed to effectively advocate for addiction treatment providers at the national and state levels. Aggregated information about treatment effectiveness, resource gaps, and emerging challenges will be made available to SAAS and its state affiliates. These data can be employed persuasively with government decision makers, funders, regulators, and the public.

The SAAS/NIATx/BPS benchmarking initiative embraces the ideal that improvement can occur within all organizations through comparative processes. The initiative will not seek to set standards for the industry. This provider-driven program will avoid a “pass-fail” approach while helping providers understand which aspects of their organizational performance are meeting expectations and which are not. Data submitted by individual organizations will be strictly confidential and will not be released to any third party, including SAAS and NIATx. Data will be submitted to and managed by BPS, an independent benchmarking and research entity. Reports will include aggregated data only.

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