In the ever-evolving landscape of healthcare, one approach has gained increasing attention for its potential to drastically improve patient outcomes: personalized SUD treatment through measurement-based care. This model, which leverages data to drive individualized treatment decisions, is hailed by both providers and payers as a cornerstone of evidence-based care. The power of this approach lies not just in collecting data, but in actively using that data to make informed decisions, adjust treatments, engage patients, and provide valuable insights to stakeholders.
For substance use disorder (SUD) providers eager to craft new reimbursement arrangements or improve patient outcomes, the journey begins with a critical investment in robust internal measurement systems. Personalized SUD treatment can’t be achieved by simply gathering data; it’s how providers leverage that data to drive patient-centered decisions that makes the real difference.
The Importance of Using Data to Drive Personalized SUD Treatment
Dr. Suzette Glasner, Chief Scientific Officer at Pelago, a provider of virtual care for patients struggling with tobacco, alcohol, opioid, and cannabis use disorders, underscored the significance of a measurement-based care model during her presentation at the Behavioral Health Business Autism & Addiction Treatment Forum. Dr. Glasner explained that when healthcare providers gather data to improve patient outcomes, it’s essential that this data actively informs and shapes the course of personalized SUD treatment. The real power of measurement-based care is how it directly impacts the individualized treatment plan that each patient follows. By actively using data to adjust care pathways, providers can make real-time decisions to enhance patient engagement and overall treatment efficacy.
Pelago’s approach to personalized SUD treatment centers around therapies like cognitive behavioral therapy (CBT), motivational enhancement therapy (MET), and contingency management. By collecting extensive data, both at the patient and enterprise level, Pelago can ensure that each patient receives a personalized and evidence-based treatment experience that continually adapts to their evolving needs.
Moving Beyond Data Collection to Action: The Key to Personalized SUD Treatment
Simply gathering data isn’t enough. SUD treatment providers must establish systems that allow them to take actionable steps based on the data they collect. Without this critical step, even the most sophisticated data systems fail to drive meaningful change. This is where many healthcare providers fall short—collecting data, but not having the tools or strategies in place to effectively use it to inform treatment.
Pelago’s digital platform allows clinicians to track patient progress in real time, using a comprehensive dashboard that displays metrics related to patient stability, relapse, and overall recovery. This enables providers to intervene promptly if a patient’s situation changes or if treatment needs adjustment. By monitoring key metrics continuously, Pelago ensures that treatment is not static but dynamic, evolving as patients move through their recovery journey. Personalized SUD treatment requires constant reassessment and refinement based on individual progress, making real-time data crucial.
Identifying Key Metrics: What Should Providers Measure in Personalized SUD Treatment?
Before diving into data collection, it’s crucial for providers to decide what to measure. Identifying which metrics are most important to patients can vary depending on the treatment philosophy, target population, and desired outcomes. Measurement must be tailored to the specific needs of the population being served, especially when aiming for personalized SUD treatment.
For example, Boulder Care, a digital SUD provider, tracks several critical metrics that directly reflect the quality and effectiveness of care. These include patient satisfaction, treatment retention, and quality of life outcomes. Rose Bromka, Chief Operating Officer at Boulder Care, explains that quality of life outcomes can include aspects such as reuniting with family members, regaining a driver’s license, returning to school, or even getting a work promotion. These broader life changes signal significant recovery milestones beyond just clinical markers, offering a fuller picture of a patient’s journey.
Boulder Care’s “gold standard quality metric” is its retention in care rate, which is a direct indicator of the company’s ability to maintain patient engagement. Over 85% of Boulder’s patients are Medicaid beneficiaries, and the provider uses claims data to demonstrate that patients who remain in treatment see significant reductions in emergency room visits and inpatient stays—anywhere from 40% to 70%—showing the clear link between ongoing care and improved health outcomes.
Similarly, Recovery Centers of America (RCA) measures retention and engagement, using metrics that track how often patients complete their inpatient care and move through the full continuum of care offered by RCA’s facilities. The provider also tracks patient satisfaction through surveys conducted both post-treatment and during the treatment process. This data allows RCA to make actionable improvements at both the operational and clinical levels.
Embracing Harm Reduction and Alternative Metrics
The focus of SUD treatment often hinges on the debate between complete abstinence and harm reduction. Some providers, such as Pelago, incorporate harm reduction principles into their measurement-based care models. Dr. Glasner explains that while complete abstinence is considered the “gold standard” for outcomes, some patients may not be ready or willing to fully abstain from substances. In these cases, reducing the amount of substance use can be a more feasible and effective goal.
For Pelago’s alcohol use disorder patients, this harm reduction approach shows tangible benefits. On average, patients enter treatment consuming six to seven drinks on drinking days. After 12 weeks of care, this consumption drops to just two drinks on drinking days. Additionally, Pelago measures abstinence rates and tracks patients’ drinking risk levels as defined by the World Health Organization (WHO). These levels, ranging from low risk to very high risk, allow Pelago to track progress in reducing substance use over time, even if total abstinence is not yet achievable.
Research has shown that reducing drinking risk by just one or two levels can lead to significant improvements in health-related outcomes, and Pelago reports that nearly 70% of its population experiences this kind of improvement. This data provides strong evidence that even incremental changes in substance use can have a lasting positive impact on long-term health outcomes.
Systemic Changes for Implementing Data-Driven Personalized SUD Treatment
For SUD providers to successfully implement measurement-based care, they must often rework their clinical models from the ground up. Recovery Centers of America (RCA) did just that in 2020, retooling its entire clinical model to integrate data-driven decision-making. The result was a more individualized approach to treatment, where patients were classified into different care pathways based on data. This classification allows RCA to tailor treatment plans to each patient’s specific needs, including the level of provider involvement, treatment methods, and recovery pace.
This data-driven clinical approach is foundational for future value-based reimbursement arrangements, which emphasize paying providers based on patient outcomes rather than the volume of services rendered. For RCA, this reworked clinical model is designed not only to improve patient care but to prepare them for a new era of healthcare reimbursement that aligns treatment goals with measurable results.
However, implementing this kind of measurement-based care is not without its challenges. One major hurdle is aggregating and utilizing patient-level data. While electronic health records (EHRs) help providers collect broad, enterprise-level data, they are often not designed to track individual outcomes in real time. Without these tools, it’s challenging for providers to make informed, personalized decisions that can truly affect the course of treatment.
Providers like Pelago, Boulder Care, and RCA have embraced digital platforms that offer tools to bridge this gap. These platforms allow clinicians to collect real-time data, monitor patient progress, and make immediate adjustments to care plans—often before a patient even steps into their next appointment. This shift ensures that patients are always receiving the most relevant and effective treatment based on their current needs.
Overcoming Fee-for-Service Models: A Shift Toward Value-Based Care
The traditional fee-for-service reimbursement model—where providers are paid based on the number of clinical visits or services provided—has long been a barrier to adopting measurement-based care. This model often incentivizes volume over outcomes, which can create a disconnect between the services provided and the actual health improvements of patients.
Boulder Care has actively worked to overcome this challenge by embracing alternative payment models, such as value-based care. These models focus on the quality and effectiveness of treatment rather than the quantity of services delivered. According to Rose Bromka, Boulder’s shift to alternative payment arrangements is vital for systematically changing the industry and aligning financial incentives with patient health outcomes.
Conclusion: The Future of Personalized SUD Treatment
The future of SUD treatment is undoubtedly data-driven. By implementing measurement-based care models, providers can enhance treatment outcomes, engage patients more effectively, and contribute to a more sustainable healthcare system. The key lies not just in collecting data but in using it meaningfully to inform individualized care decisions and to track progress across a continuum of treatment.
As more SUD providers, like Pelago, Boulder Care, and RCA, continue to embrace and refine their use of measurement-based care, the industry will undoubtedly see a shift toward more personalized, outcomes-driven treatment that empowers patients, improves recovery outcomes, and creates long-term, sustainable change. This shift will also pave the way for value-based reimbursement arrangements, aligning financial incentives with positive patient outcomes, ensuring that the future of substance use disorder treatment is both effective and compassionate.
