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The Reinforcing Therapist Performance (RTP) experiment: study protocol for a cluster randomized trial.

Bryan R Garner¹, Susan H Godley, Michael L Dennis

¹Lighthouse Institute, Chestnut Health Systems, Normal, IL, USA. brgarner@chestnut.org

Implementation Science : IS

|March 9, 2010

Summary

This summary is machine-generated.

Monetary incentives for therapists improved substance abuse treatment delivery and client outcomes. This pay-for-performance (P4P) approach was evaluated for effectiveness and cost-effectiveness in improving adolescent recovery rates.

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Area of Science:

Health Services Research
Addiction Treatment
Implementation Science

Background:

The Institute of Medicine recommends rewarding provider performance to enhance treatment quality.
Empirical research on the effectiveness and cost-effectiveness of performance-based incentives in healthcare is limited.
Substance abuse treatment quality and client outcomes can potentially be improved through direct therapist incentives.

Purpose of the Study:

To evaluate the effectiveness of direct monetary incentives for therapists in improving substance abuse treatment.
To assess the cost-effectiveness of a pay-for-performance (P4P) model in substance abuse treatment.
To examine the impact of incentives on treatment service delivery and client recovery outcomes.

Main Methods:

A cluster randomized design was employed across 29 substance abuse treatment sites.
Therapists were assigned to either an implementation as usual (IAU) or a pay-for-performance (P4P) condition.
The P4P group received monetary incentives for achieving measurable quality-related behaviors in treatment delivery.

Main Results:

Effectiveness outcomes measured include increased adolescent treatment receipt, therapist competency, and adolescent recovery rates.
Cost-effectiveness outcomes assessed include cost per adolescent treated, cost per demonstrated therapist competency, and cost per adolescent recovery.
The study will determine the impact of monetary incentives on these key performance and outcome indicators.

Conclusions:

Pay-for-performance models show promise for enhancing the quality of substance abuse treatment.
Monetary incentives may be a viable strategy to improve therapist performance and client outcomes.
Further analysis will clarify the cost-effectiveness of this intervention in real-world settings.