Implementation of the methadone treatment quality assurance system. findings from the feasibility study

This article describes the development and large-scale testing of the Methadone Treatment Quality Assurance System (MTQAS). MTQAS originated as a NIDA (National Institute on Drug Abuse) funded study to assess the feasibility and utility of implementing a performance-based feedback reporting system for narcotic addiction treatment programs. After several years of research to identify a set of valid, reliable, and clinically useful indicators of program performance using patients' in-treatment outcomes, MTQAS was tested in a feasibility study with more than 70 methadone treatment clinics in seven states. For each of nine quarters, participating clinics received a report summarizing their patient outcomes; reports also included summary data permitting comparisons across states, across clinics within a state, and within a clinic over time. In addition, MTQAS included a case-mix adjustment strategy that permitted fair comparisons of performance among programs with systematically different patient caseloads. The structure and operation of MTQAS, selected analyses of the data, and lessons for future performance measurement systems are discussed.